hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|FL,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Madison County Memorial Hospital,2024-07-01,2.0.0,Madison County Memorial Hospital,"224 NW Crane Avenue Madison, FL 32340",4346,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,modifiers,standard_charge|AETNA|COMMERCIAL|negotiated_dollar,standard_charge|AETNA|COMMERCIAL|negotiated_percentage,standard_charge|AETNA|COMMERCIAL|negotiated_algorithm,estimated_amount|AETNA|COMMERCIAL,standard_charge|AETNA|COMMERCIAL|methodology,additional_payer_notes|AETNA|COMMERCIAL,standard_charge|AETNA|MEDICAL_RENTAL|negotiated_dollar,standard_charge|AETNA|MEDICAL_RENTAL|negotiated_percentage,standard_charge|AETNA|MEDICAL_RENTAL|negotiated_algorithm,estimated_amount|AETNA|MEDICAL_RENTAL,standard_charge|AETNA|MEDICAL_RENTAL|methodology,additional_payer_notes|AETNA|MEDICAL_RENTAL,standard_charge|BCBS|COMMERCIAL|negotiated_dollar,standard_charge|BCBS|COMMERCIAL|negotiated_percentage,standard_charge|BCBS|COMMERCIAL|negotiated_algorithm,estimated_amount|BCBS|COMMERCIAL,standard_charge|BCBS|COMMERCIAL|methodology,additional_payer_notes|BCBS|COMMERCIAL,standard_charge|CLEAR_ALLIANCE|COMMERCIAL|negotiated_dollar,standard_charge|CLEAR_ALLIANCE|COMMERCIAL|negotiated_percentage,standard_charge|CLEAR_ALLIANCE|COMMERCIAL|negotiated_algorithm,estimated_amount|CLEAR_ALLIANCE|COMMERCIAL,standard_charge|CLEAR_ALLIANCE|COMMERCIAL|methodology,additional_payer_notes|CLEAR_ALLIANCE|COMMERCIAL,standard_charge|HUMANA|EPO|negotiated_dollar,standard_charge|HUMANA|EPO|negotiated_percentage,standard_charge|HUMANA|EPO|negotiated_algorithm,estimated_amount|HUMANA|EPO,standard_charge|HUMANA|EPO|methodology,additional_payer_notes|HUMANA|EPO,standard_charge|HUMANA|HMO|negotiated_dollar,standard_charge|HUMANA|HMO|negotiated_percentage,standard_charge|HUMANA|HMO|negotiated_algorithm,estimated_amount|HUMANA|HMO,standard_charge|HUMANA|HMO|methodology,additional_payer_notes|HUMANA|HMO,standard_charge|HUMANA|MEDICAID_ADVANTAGE_HMO|negotiated_dollar,standard_charge|HUMANA|MEDICAID_ADVANTAGE_HMO|negotiated_percentage,standard_charge|HUMANA|MEDICAID_ADVANTAGE_HMO|negotiated_algorithm,estimated_amount|HUMANA|MEDICAID_ADVANTAGE_HMO,standard_charge|HUMANA|MEDICAID_ADVANTAGE_HMO|methodology,additional_payer_notes|HUMANA|MEDICAID_ADVANTAGE_HMO,standard_charge|HUMANA|MEDICAID_ADVANTAGE_TRADITIONAL|negotiated_dollar,standard_charge|HUMANA|MEDICAID_ADVANTAGE_TRADITIONAL|negotiated_percentage,standard_charge|HUMANA|MEDICAID_ADVANTAGE_TRADITIONAL|negotiated_algorithm,estimated_amount|HUMANA|MEDICAID_ADVANTAGE_TRADITIONAL,standard_charge|HUMANA|MEDICAID_ADVANTAGE_TRADITIONAL|methodology,additional_payer_notes|HUMANA|MEDICAID_ADVANTAGE_TRADITIONAL,standard_charge|HUMANA|POS|negotiated_dollar,standard_charge|HUMANA|POS|negotiated_percentage,standard_charge|HUMANA|POS|negotiated_algorithm,estimated_amount|HUMANA|POS,standard_charge|HUMANA|POS|methodology,additional_payer_notes|HUMANA|POS,standard_charge|HUMANA|PPO|negotiated_dollar,standard_charge|HUMANA|PPO|negotiated_percentage,standard_charge|HUMANA|PPO|negotiated_algorithm,estimated_amount|HUMANA|PPO,standard_charge|HUMANA|PPO|methodology,additional_payer_notes|HUMANA|PPO,standard_charge|LIGHTHOUSE|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|LIGHTHOUSE|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|LIGHTHOUSE|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|LIGHTHOUSE|MEDICAID_ADVANTAGE,standard_charge|LIGHTHOUSE|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|LIGHTHOUSE|MEDICAID_ADVANTAGE,standard_charge|MAGELLAN|MEDICAID|negotiated_dollar,standard_charge|MAGELLAN|MEDICAID|negotiated_percentage,standard_charge|MAGELLAN|MEDICAID|negotiated_algorithm,estimated_amount|MAGELLAN|MEDICAID,standard_charge|MAGELLAN|MEDICAID|methodology,additional_payer_notes|MAGELLAN|MEDICAID,standard_charge|MOLINA|FLORIDA_KID_CARE|negotiated_dollar,standard_charge|MOLINA|FLORIDA_KID_CARE|negotiated_percentage,standard_charge|MOLINA|FLORIDA_KID_CARE|negotiated_algorithm,estimated_amount|MOLINA|FLORIDA_KID_CARE,standard_charge|MOLINA|FLORIDA_KID_CARE|methodology,additional_payer_notes|MOLINA|FLORIDA_KID_CARE,standard_charge|MOLINA|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|MOLINA|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|MOLINA|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|MOLINA|MEDICAID_ADVANTAGE,standard_charge|MOLINA|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|MOLINA|MEDICAID_ADVANTAGE,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_dollar,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_percentage,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_algorithm,estimated_amount|MULTIPLAN|COMMERCIAL,standard_charge|MULTIPLAN|COMMERCIAL|methodology,additional_payer_notes|MULTIPLAN|COMMERCIAL,standard_charge|MULTIPLAN|COMPLIMENTARY_NETWORK|negotiated_dollar,standard_charge|MULTIPLAN|COMPLIMENTARY_NETWORK|negotiated_percentage,standard_charge|MULTIPLAN|COMPLIMENTARY_NETWORK|negotiated_algorithm,estimated_amount|MULTIPLAN|COMPLIMENTARY_NETWORK,standard_charge|MULTIPLAN|COMPLIMENTARY_NETWORK|methodology,additional_payer_notes|MULTIPLAN|COMPLIMENTARY_NETWORK,standard_charge|PRESTIGE_HEALTH_CHOICE|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|PRESTIGE_HEALTH_CHOICE|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|PRESTIGE_HEALTH_CHOICE|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|PRESTIGE_HEALTH_CHOICE|MEDICAID_ADVANTAGE,standard_charge|PRESTIGE_HEALTH_CHOICE|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|PRESTIGE_HEALTH_CHOICE|MEDICAID_ADVANTAGE,standard_charge|PRIME_HEALTH|MEDICARE|negotiated_dollar,standard_charge|PRIME_HEALTH|MEDICARE|negotiated_percentage,standard_charge|PRIME_HEALTH|MEDICARE|negotiated_algorithm,estimated_amount|PRIME_HEALTH|MEDICARE,standard_charge|PRIME_HEALTH|MEDICARE|methodology,additional_payer_notes|PRIME_HEALTH|MEDICARE,standard_charge|SIMPLY_HEALTH|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|SIMPLY_HEALTH|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|SIMPLY_HEALTH|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|SIMPLY_HEALTH|MEDICAID_ADVANTAGE,standard_charge|SIMPLY_HEALTH|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|SIMPLY_HEALTH|MEDICAID_ADVANTAGE,standard_charge|SUNSHINE_HEALTHY_KIDS|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|SUNSHINE_HEALTHY_KIDS|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|SUNSHINE_HEALTHY_KIDS|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|SUNSHINE_HEALTHY_KIDS|MEDICAID_ADVANTAGE,standard_charge|SUNSHINE_HEALTHY_KIDS|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|SUNSHINE_HEALTHY_KIDS|MEDICAID_ADVANTAGE,standard_charge|SUNSHINE|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|SUNSHINE|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|SUNSHINE|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|SUNSHINE|MEDICAID_ADVANTAGE,standard_charge|SUNSHINE|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|SUNSHINE|MEDICAID_ADVANTAGE,standard_charge|UHC|COMMERCIAL|negotiated_dollar,standard_charge|UHC|COMMERCIAL|negotiated_percentage,standard_charge|UHC|COMMERCIAL|negotiated_algorithm,estimated_amount|UHC|COMMERCIAL,standard_charge|UHC|COMMERCIAL|methodology,additional_payer_notes|UHC|COMMERCIAL,standard_charge|UHC|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|UHC|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|UHC|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|UHC|MEDICAID_ADVANTAGE,standard_charge|UHC|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|UHC|MEDICAID_ADVANTAGE,standard_charge|WELLCARE|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|WELLCARE|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|WELLCARE|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|WELLCARE|MEDICAID_ADVANTAGE,standard_charge|WELLCARE|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|WELLCARE|MEDICAID_ADVANTAGE,standard_charge|YOUTH_SERVICES|MEDICAID_ADVANTAGE|negotiated_dollar,standard_charge|YOUTH_SERVICES|MEDICAID_ADVANTAGE|negotiated_percentage,standard_charge|YOUTH_SERVICES|MEDICAID_ADVANTAGE|negotiated_algorithm,estimated_amount|YOUTH_SERVICES|MEDICAID_ADVANTAGE,standard_charge|YOUTH_SERVICES|MEDICAID_ADVANTAGE|methodology,additional_payer_notes|YOUTH_SERVICES|MEDICAID_ADVANTAGE,standard_charge|AETNA|MEDICARE|negotiated_dollar,standard_charge|AETNA|MEDICARE|negotiated_percentage,standard_charge|AETNA|MEDICARE|negotiated_algorithm,estimated_amount|AETNA|MEDICARE,standard_charge|AETNA|MEDICARE|methodology,additional_payer_notes|AETNA|MEDICARE,standard_charge|HUMANA|MEDICARE_HMO|negotiated_dollar,standard_charge|HUMANA|MEDICARE_HMO|negotiated_percentage,standard_charge|HUMANA|MEDICARE_HMO|negotiated_algorithm,estimated_amount|HUMANA|MEDICARE_HMO,standard_charge|HUMANA|MEDICARE_HMO|methodology,additional_payer_notes|HUMANA|MEDICARE_HMO,standard_charge|HUMANA|MEDICARE_PPO|negotiated_dollar,standard_charge|HUMANA|MEDICARE_PPO|negotiated_percentage,standard_charge|HUMANA|MEDICARE_PPO|negotiated_algorithm,estimated_amount|HUMANA|MEDICARE_PPO,standard_charge|HUMANA|MEDICARE_PPO|methodology,additional_payer_notes|HUMANA|MEDICARE_PPO,standard_charge|HUMANA|MEDICARE_POS|negotiated_dollar,standard_charge|HUMANA|MEDICARE_POS|negotiated_percentage,standard_charge|HUMANA|MEDICARE_POS|negotiated_algorithm,estimated_amount|HUMANA|MEDICARE_POS,standard_charge|HUMANA|MEDICARE_POS|methodology,additional_payer_notes|HUMANA|MEDICARE_POS,standard_charge|HUMANA|MEDICARE_PFFS|negotiated_dollar,standard_charge|HUMANA|MEDICARE_PFFS|negotiated_percentage,standard_charge|HUMANA|MEDICARE_PFFS|negotiated_algorithm,estimated_amount|HUMANA|MEDICARE_PFFS,standard_charge|HUMANA|MEDICARE_PFFS|methodology,additional_payer_notes|HUMANA|MEDICARE_PFFS,standard_charge|MOLINA|MEDICARE|negotiated_dollar,standard_charge|MOLINA|MEDICARE|negotiated_percentage,standard_charge|MOLINA|MEDICARE|negotiated_algorithm,estimated_amount|MOLINA|MEDICARE,standard_charge|MOLINA|MEDICARE|methodology,additional_payer_notes|MOLINA|MEDICARE,standard_charge|MULTIPLAN|MEDICARE|negotiated_dollar,standard_charge|MULTIPLAN|MEDICARE|negotiated_percentage,standard_charge|MULTIPLAN|MEDICARE|negotiated_algorithm,estimated_amount|MULTIPLAN|MEDICARE,standard_charge|MULTIPLAN|MEDICARE|methodology,additional_payer_notes|MULTIPLAN|MEDICARE,standard_charge|SUNSHINE|COMMERCIAL|negotiated_dollar,standard_charge|SUNSHINE|COMMERCIAL|negotiated_percentage,standard_charge|SUNSHINE|COMMERCIAL|negotiated_algorithm,estimated_amount|SUNSHINE|COMMERCIAL,standard_charge|SUNSHINE|COMMERCIAL|methodology,additional_payer_notes|SUNSHINE|COMMERCIAL,standard_charge|SUNSHINE|MEDICARE|negotiated_dollar,standard_charge|SUNSHINE|MEDICARE|negotiated_percentage,standard_charge|SUNSHINE|MEDICARE|negotiated_algorithm,estimated_amount|SUNSHINE|MEDICARE,standard_charge|SUNSHINE|MEDICARE|methodology,additional_payer_notes|SUNSHINE|MEDICARE,standard_charge|SUNSHINE|COMMERCIAL_EXCHANGE|negotiated_dollar,standard_charge|SUNSHINE|COMMERCIAL_EXCHANGE|negotiated_percentage,standard_charge|SUNSHINE|COMMERCIAL_EXCHANGE|negotiated_algorithm,estimated_amount|SUNSHINE|COMMERCIAL_EXCHANGE,standard_charge|SUNSHINE|COMMERCIAL_EXCHANGE|methodology,additional_payer_notes|SUNSHINE|COMMERCIAL_EXCHANGE,standard_charge|UHC|MEDICARE|negotiated_dollar,standard_charge|UHC|MEDICARE|negotiated_percentage,standard_charge|UHC|MEDICARE|negotiated_algorithm,estimated_amount|UHC|MEDICARE,standard_charge|UHC|MEDICARE|methodology,additional_payer_notes|UHC|MEDICARE,standard_charge|UHC|VETERANS|negotiated_dollar,standard_charge|UHC|VETERANS|negotiated_percentage,standard_charge|UHC|VETERANS|negotiated_algorithm,estimated_amount|UHC|VETERANS,standard_charge|UHC|VETERANS|methodology,additional_payer_notes|UHC|VETERANS,standard_charge|BCBS|MEDICARE_ADVANTAGE|negotiated_dollar,standard_charge|BCBS|MEDICARE_ADVANTAGE|negotiated_percentage,standard_charge|BCBS|MEDICARE_ADVANTAGE|negotiated_algorithm,estimated_amount|BCBS|MEDICARE_ADVANTAGE,standard_charge|BCBS|MEDICARE_ADVANTAGE|methodology,additional_payer_notes|BCBS|MEDICARE_ADVANTAGE,standard_charge|LIGHTHOUSE|MEDICARE_ADVANTAGE|negotiated_dollar,standard_charge|LIGHTHOUSE|MEDICARE_ADVANTAGE|negotiated_percentage,standard_charge|LIGHTHOUSE|MEDICARE_ADVANTAGE|negotiated_algorithm,estimated_amount|LIGHTHOUSE|MEDICARE_ADVANTAGE,standard_charge|LIGHTHOUSE|MEDICARE_ADVANTAGE|methodology,additional_payer_notes|LIGHTHOUSE|MEDICARE_ADVANTAGE,standard_charge|min,standard_charge|max,additional_generic_notes
[4 MG/ML],3500427,CDM,636,RC,J1170,HCPCS,outpatient,,,15.4,7.7,,,,,,other,Not reimbursable per contract ,10.47,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.08,20,,,percent of total billed charges,20% of total billed charges,3.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.08,20,,,percent of total billed charges,20% of total billed charges,3.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.32,80,,,case rate,80% for high cost drug carve out,13.09,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,13.09,
10 MM RETRIEVAL,6215829,CDM,272,RC,,,outpatient,,,220,110,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44,143,
121-150 MIN ANESTHESIA,3220271,CDM,370,RC,,,outpatient,,,1028,514,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.6,20,,,percent of total billed charges,20% of total billed charges,205.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.6,20,,,percent of total billed charges,20% of total billed charges,205.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,668.2,65,,,percent of total billed charges,65% of total billed charges,668.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,668.2,
12X100 BALLOON BLUNT TIP,6215825,CDM,272,RC,,,outpatient,,,121,60.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.2,20,,,percent of total billed charges,20% of total billed charges,24.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.2,20,,,percent of total billed charges,20% of total billed charges,24.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.65,65,,,percent of total billed charges,65% of total billed charges,78.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.2,78.65,
12X100 KII SLEEVE,6215827,CDM,272,RC,,,outpatient,,,83.93,41.97,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.79,20,,,percent of total billed charges,20% of total billed charges,16.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.79,20,,,percent of total billed charges,20% of total billed charges,16.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.55,65,,,percent of total billed charges,65% of total billed charges,54.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.79,54.55,
21- Hydroxylase Antibody,3300936,CDM,300,RC,83516,HCPCS,outpatient,,,107,53.5,,69.55,65,,,percent of total billed charges,65% of total billed charges,72.76,68,,,percent of total billed charges,68% of total billed charges,16.38,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.55,65,,,percent of total billed charges,65% of total billed charges,69.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,72.76,
25G INTERJECT CLEAR,6215816,CDM,272,RC,,,outpatient,,,209.17,104.59,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.83,20,,,percent of total billed charges,20% of total billed charges,41.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.83,20,,,percent of total billed charges,20% of total billed charges,41.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.96,65,,,percent of total billed charges,65% of total billed charges,135.96,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.83,135.96,
31-60 MIN ANESTHESIA,3220269,CDM,370,RC,,,outpatient,,,631,315.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.2,20,,,percent of total billed charges,20% of total billed charges,126.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.2,20,,,percent of total billed charges,20% of total billed charges,126.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,410.15,65,,,percent of total billed charges,65% of total billed charges,410.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,378.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,410.15,
37.5 COMBAT TOURNIQUET,2000185,CDM,271,RC,,,outpatient,,,149.71,74.86,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.94,20,,,percent of total billed charges,20% of total billed charges,29.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.94,20,,,percent of total billed charges,20% of total billed charges,29.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.31,65,,,percent of total billed charges,65% of total billed charges,97.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,97.31,
5X100 DUAL PACK,6215824,CDM,272,RC,,,outpatient,,,119.19,59.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.84,20,,,percent of total billed charges,20% of total billed charges,23.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.84,20,,,percent of total billed charges,20% of total billed charges,23.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.47,65,,,percent of total billed charges,65% of total billed charges,77.47,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.84,77.47,
5X100 KII SLEEVE,6215828,CDM,272,RC,,,outpatient,,,52.8,26.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.56,20,,,percent of total billed charges,20% of total billed charges,10.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.56,20,,,percent of total billed charges,20% of total billed charges,10.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.32,65,,,percent of total billed charges,65% of total billed charges,34.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,53.67,
"6.0 ENDOTRACH, STYLETTE",6215747,CDM,272,RC,,,outpatient,,,27.6,13.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.52,20,,,percent of total billed charges,20% of total billed charges,5.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.52,20,,,percent of total billed charges,20% of total billed charges,5.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.94,65,,,percent of total billed charges,65% of total billed charges,17.94,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.52,53.67,
6.5 COMBAT TOURNIQUET,2000184,CDM,271,RC,,,outpatient,,,149.71,74.86,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.94,20,,,percent of total billed charges,20% of total billed charges,29.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.94,20,,,percent of total billed charges,20% of total billed charges,29.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.31,65,,,percent of total billed charges,65% of total billed charges,97.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,97.31,
6.5 ENDOTRACH,6215748,CDM,272,RC,,,outpatient,,,27.6,13.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.52,20,,,percent of total billed charges,20% of total billed charges,5.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.52,20,,,percent of total billed charges,20% of total billed charges,5.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.94,65,,,percent of total billed charges,65% of total billed charges,17.94,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.52,53.67,
61-90 MIN ANESTHESIA,3220265,CDM,370,RC,,,outpatient,,,696,348,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,139.2,20,,,percent of total billed charges,20% of total billed charges,139.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,139.2,20,,,percent of total billed charges,20% of total billed charges,139.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,452.4,65,,,percent of total billed charges,65% of total billed charges,452.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,417.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,452.4,
7.0 ENDOTRACH,6215749,CDM,272,RC,,,outpatient,,,30.9,15.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.18,20,,,percent of total billed charges,20% of total billed charges,6.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.18,20,,,percent of total billed charges,20% of total billed charges,6.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.09,65,,,percent of total billed charges,65% of total billed charges,20.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,53.67,
7.5 ENDOTRACH,6215750,CDM,272,RC,,,outpatient,,,30.9,15.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.18,20,,,percent of total billed charges,20% of total billed charges,6.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.18,20,,,percent of total billed charges,20% of total billed charges,6.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.09,65,,,percent of total billed charges,65% of total billed charges,20.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,53.67,
8.0 ENDOTRACH,6215751,CDM,272,RC,,,outpatient,,,30.35,15.18,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.07,20,,,percent of total billed charges,20% of total billed charges,6.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.07,20,,,percent of total billed charges,20% of total billed charges,6.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.73,65,,,percent of total billed charges,65% of total billed charges,19.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.07,53.67,
91-120 MIN ANESTHESIA,3220267,CDM,370,RC,,,outpatient,,,862,431,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,172.4,20,,,percent of total billed charges,20% of total billed charges,172.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,172.4,20,,,percent of total billed charges,20% of total billed charges,172.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,560.3,65,,,percent of total billed charges,65% of total billed charges,560.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,517.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,560.3,
A C JOINTS BIL,3400010,CDM,320,RC,73050,HCPCS,outpatient,,,153,76.5,,99.45,65,,,percent of total billed charges,65% of total billed charges,104.04,68,,,percent of total billed charges,68% of total billed charges,22.37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.45,65,,,percent of total billed charges,65% of total billed charges,99.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.37,180,
ABD PADS 8X10,3250387,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
ABDOMEN 2/VIEWS,3400001,CDM,320,RC,74019,HCPCS,outpatient,,,240,120,,156,65,,,percent of total billed charges,65% of total billed charges,163.2,68,,,percent of total billed charges,68% of total billed charges,20.68,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,20,,,percent of total billed charges,20% of total billed charges,48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,20,,,percent of total billed charges,20% of total billed charges,48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156,65,,,percent of total billed charges,65% of total billed charges,156,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.68,180,
ABDOMEN 2/VIEWS,3440007,CDM,972,RC,74019,HCPCS,outpatient,,,72.6,36.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.39,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.79,110,,,fee schedule,110% of Medicare physician fee schedule,39.79,110,,,fee schedule,110% of Medicare physician fee schedule,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,218,115,,,fee schedule,115% of Medicare physician fee schedule,70.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.39,218,
ABDOMINAL PARACENTESIS W/O IMAGING,3462089,CDM,982,RC,49082,HCPCS,outpatient,,,292,146,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,49.68,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.07,110,,,fee schedule,110% of Medicare physician fee schedule,82.07,110,,,fee schedule,110% of Medicare physician fee schedule,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.8,115,,,fee schedule,115% of Medicare physician fee schedule,102.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.68,102.28,
ABDOMINAL SERIES,3400112,CDM,320,RC,74022,HCPCS,outpatient,,,220,110,,143,65,,,percent of total billed charges,65% of total billed charges,149.6,68,,,percent of total billed charges,68% of total billed charges,24.76,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.76,180,
ABDOMINAL SERIES,3440303,CDM,972,RC,74022,HCPCS,outpatient,,,89.1,44.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.45,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.85,110,,,fee schedule,110% of Medicare physician fee schedule,53.85,110,,,fee schedule,110% of Medicare physician fee schedule,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,232.69,115,,,fee schedule,115% of Medicare physician fee schedule,77.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,24.45,232.69,
ABG ANALYSIS,3170067,CDM,301,RC,82803,HCPCS,outpatient,,,290,145,,188.5,65,,,percent of total billed charges,65% of total billed charges,197.2,68,,,percent of total billed charges,68% of total billed charges,27.47,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58,20,,,percent of total billed charges,20% of total billed charges,58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58,20,,,percent of total billed charges,20% of total billed charges,58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,188.5,65,,,percent of total billed charges,65% of total billed charges,188.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,145,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.47,197.2,
ABG PUNCTURE,3170103,CDM,301,RC,36600,HCPCS,outpatient,,,83,41.5,,53.95,65,,,percent of total billed charges,65% of total billed charges,56.44,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.95,65,,,percent of total billed charges,65% of total billed charges,53.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.6,178,
ABO BLOOD TYPE,3300779,CDM,309,RC,86900,HCPCS,outpatient,,,51,25.5,,33.15,65,,,percent of total billed charges,65% of total billed charges,34.68,68,,,percent of total billed charges,68% of total billed charges,4.23,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,34.68,
ABSOLUTE NEUTROPHIL COUNT,3300662,CDM,305,RC,85048,HCPCS,outpatient,,,24,12,,15.6,65,,,percent of total billed charges,65% of total billed charges,16.32,68,,,percent of total billed charges,68% of total billed charges,3.61,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.8,20,,,percent of total billed charges,20% of total billed charges,4.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.8,20,,,percent of total billed charges,20% of total billed charges,4.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,65,,,percent of total billed charges,65% of total billed charges,15.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.61,16.32,
ABSORBABLE HEMOSTAT 2X14,6215904,CDM,272,RC,,,outpatient,,,182.1,91.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.42,20,,,percent of total billed charges,20% of total billed charges,36.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.42,20,,,percent of total billed charges,20% of total billed charges,36.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,118.37,65,,,percent of total billed charges,65% of total billed charges,118.37,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.42,118.37,
AC JOINTS BIL,3440003,CDM,972,RC,73050,HCPCS,outpatient,,,86,43,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.4,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.91,110,,,fee schedule,110% of Medicare physician fee schedule,30.91,110,,,fee schedule,110% of Medicare physician fee schedule,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.72,115,,,fee schedule,115% of Medicare physician fee schedule,72,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.4,208.72,
ACAPELLA SECRETION CLEARANCE DEVICE,3170118,CDM,272,RC,,,outpatient,,,211.53,105.77,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.31,20,,,percent of total billed charges,20% of total billed charges,42.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.31,20,,,percent of total billed charges,20% of total billed charges,42.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.49,65,,,percent of total billed charges,65% of total billed charges,137.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.31,137.49,
ACCU-CHECK,3020935,CDM,301,RC,82962,HCPCS,outpatient,,,6.3,3.15,,4.1,65,,,percent of total billed charges,65% of total billed charges,4.28,68,,,percent of total billed charges,68% of total billed charges,4.49,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.26,20,,,percent of total billed charges,20% of total billed charges,1.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.26,20,,,percent of total billed charges,20% of total billed charges,1.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.1,65,,,percent of total billed charges,65% of total billed charges,4.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.26,4.49,
ACCU-CHECK,3230935,CDM,301,RC,82962,HCPCS,outpatient,,,6.3,3.15,,4.1,65,,,percent of total billed charges,65% of total billed charges,4.28,68,,,percent of total billed charges,68% of total billed charges,4.49,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.26,20,,,percent of total billed charges,20% of total billed charges,1.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.26,20,,,percent of total billed charges,20% of total billed charges,1.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.1,65,,,percent of total billed charges,65% of total billed charges,4.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.26,4.49,
ACE BANDAGE 2 INCH,3250055,CDM,271,RC,,,outpatient,,,7.2,3.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,20,,,percent of total billed charges,20% of total billed charges,1.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,20,,,percent of total billed charges,20% of total billed charges,1.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.68,65,,,percent of total billed charges,65% of total billed charges,4.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,53.67,
ACE BANDAGE 3 INCH,3250057,CDM,271,RC,,,outpatient,,,6.8,3.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.36,20,,,percent of total billed charges,20% of total billed charges,1.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.36,20,,,percent of total billed charges,20% of total billed charges,1.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.42,65,,,percent of total billed charges,65% of total billed charges,4.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.36,53.67,
ACE BANDAGE 4 INCH,3250059,CDM,271,RC,,,outpatient,,,8.75,4.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.75,20,,,percent of total billed charges,20% of total billed charges,1.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.75,20,,,percent of total billed charges,20% of total billed charges,1.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.69,65,,,percent of total billed charges,65% of total billed charges,5.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.75,53.67,
ACE BANDAGE 6 INCH,3250061,CDM,271,RC,,,outpatient,,,14.95,7.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.99,20,,,percent of total billed charges,20% of total billed charges,2.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.99,20,,,percent of total billed charges,20% of total billed charges,2.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,65,,,percent of total billed charges,65% of total billed charges,9.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.99,53.67,
ACET/ BUTAL/ CAFF TAB [32,3500002,CDM,250,RC,,,outpatient,,,14.7,7.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.94,20,,,percent of total billed charges,20% of total billed charges,2.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.94,20,,,percent of total billed charges,20% of total billed charges,2.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.56,65,,,percent of total billed charges,65% of total billed charges,9.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.94,53.67,
ACET/ BUTAL/ CAFF TAB [50,3500003,CDM,250,RC,,,outpatient,,,6,3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.2,20,,,percent of total billed charges,20% of total billed charges,1.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.2,20,,,percent of total billed charges,20% of total billed charges,1.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.9,65,,,percent of total billed charges,65% of total billed charges,3.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.2,53.67,
ACETAMINOPHEN,3300201,CDM,301,RC,80329,HCPCS,outpatient,,,88,44,,57.2,65,,,percent of total billed charges,65% of total billed charges,59.84,68,,,percent of total billed charges,68% of total billed charges,39.56,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.2,65,,,percent of total billed charges,65% of total billed charges,57.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.6,59.84,
ACETAMINOPHEN ADULT SUPP,3500006,CDM,250,RC,,,outpatient,,,5.8,2.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.16,20,,,percent of total billed charges,20% of total billed charges,1.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.16,20,,,percent of total billed charges,20% of total billed charges,1.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.77,65,,,percent of total billed charges,65% of total billed charges,3.77,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.16,53.67,
ACETAMINOPHEN CHILD SUPP,3500007,CDM,250,RC,,,outpatient,,,5.75,2.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
ACETAMINOPHEN LIQ [650 MG,3500010,CDM,250,RC,,,outpatient,,,10.25,5.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.05,20,,,percent of total billed charges,20% of total billed charges,2.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.05,20,,,percent of total billed charges,20% of total billed charges,2.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.66,65,,,percent of total billed charges,65% of total billed charges,6.66,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.05,53.67,
ACETAMINOPHEN TAB [325 MG,3500011,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
ACETAMINOPHEN TAB [500 MG,3500012,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
ACETAMINOPHEN TAB ER [650 MG,3501085,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
ACETONE (SERUM),3300029,CDM,301,RC,82009,HCPCS,outpatient,,,70,35,,45.5,65,,,percent of total billed charges,65% of total billed charges,47.6,68,,,percent of total billed charges,68% of total billed charges,6.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,65,,,percent of total billed charges,65% of total billed charges,45.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.41,47.6,
ACETYLCYSTEINE,3170003,CDM,636,RC,J0132,HCPCS,outpatient,,,22,11,,,,,,other,Not reimbursable per contract ,14.96,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,80,,,case rate,80% for high cost drug carve out,18.7,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,18.7,
ACETYLCYSTEINE SOL 20% 30ml,3500016,CDM,636,RC,J0132,HCPCS,outpatient,,,41.7,20.85,,,,,,other,Not reimbursable per contract ,28.36,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.34,20,,,percent of total billed charges,20% of total billed charges,8.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.34,20,,,percent of total billed charges,20% of total billed charges,8.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.36,80,,,case rate,80% for high cost drug carve out,35.45,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,35.45,
ACID PHOSPHATASE,3300081,CDM,301,RC,84060,HCPCS,outpatient,,,88,44,,57.2,65,,,percent of total billed charges,65% of total billed charges,59.84,68,,,percent of total billed charges,68% of total billed charges,10.48,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.2,65,,,percent of total billed charges,65% of total billed charges,57.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.48,59.84,
ACTH,3300367,CDM,301,RC,82024,HCPCS,outpatient,,,188,94,,122.2,65,,,percent of total billed charges,65% of total billed charges,127.84,68,,,percent of total billed charges,68% of total billed charges,54.83,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.6,20,,,percent of total billed charges,20% of total billed charges,37.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.6,20,,,percent of total billed charges,20% of total billed charges,37.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.2,65,,,percent of total billed charges,65% of total billed charges,122.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.6,127.84,
ACTICOAT 7,3521931,CDM,272,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
ACTIVASE [VIAL] 100 MG,3501070,CDM,636,RC,J2997,HCPCS,outpatient,,,13241.85,6620.93,,8607.2,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,9004.46,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2648.37,20,,,percent of total billed charges,20% of total billed charges,2648.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2648.37,20,,,percent of total billed charges,20% of total billed charges,2648.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10593.48,80,,,case rate,80% for high cost drug carve out,11255.57,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7945.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2648.37,11255.57,
ACYCLOVIR TAB [400 MG],3501040,CDM,250,RC,,,outpatient,,,10.85,5.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.17,20,,,percent of total billed charges,20% of total billed charges,2.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.17,20,,,percent of total billed charges,20% of total billed charges,2.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.05,65,,,percent of total billed charges,65% of total billed charges,7.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.17,53.67,
ADAPTIC 3X3 DRESSING,3250309,CDM,272,RC,,,outpatient,,,4.15,2.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.83,20,,,percent of total billed charges,20% of total billed charges,0.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.83,20,,,percent of total billed charges,20% of total billed charges,0.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.7,65,,,percent of total billed charges,65% of total billed charges,2.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.83,53.67,
ADAPTIC 3X8 DRESSING,3250307,CDM,272,RC,,,outpatient,,,10.15,5.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.03,20,,,percent of total billed charges,20% of total billed charges,2.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.03,20,,,percent of total billed charges,20% of total billed charges,2.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.6,65,,,percent of total billed charges,65% of total billed charges,6.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.03,53.67,
ADAPTIC 3X8 PK,3250531,CDM,272,RC,,,outpatient,,,16.25,8.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,20,,,percent of total billed charges,20% of total billed charges,3.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,20,,,percent of total billed charges,20% of total billed charges,3.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.56,65,,,percent of total billed charges,65% of total billed charges,10.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.25,53.67,
ADENOSINE INJ [6 MG/2 ML],3500022,CDM,636,RC,J0153,HCPCS,outpatient,,,33.5,16.75,,,,,,other,Not reimbursable per contract ,22.78,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.7,20,,,percent of total billed charges,20% of total billed charges,6.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.7,20,,,percent of total billed charges,20% of total billed charges,6.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.8,80,,,case rate,80% for high cost drug carve out,28.48,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.7,28.48,
ADLT TRACHEOSTOMY TB,3170063,CDM,272,RC,,,outpatient,,,246.4,123.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.28,20,,,percent of total billed charges,20% of total billed charges,49.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.28,20,,,percent of total billed charges,20% of total billed charges,49.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.16,65,,,percent of total billed charges,65% of total billed charges,160.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.28,160.16,
ADM MODERNA BOOSTER,3040033,CDM,771,RC,0013A,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,85,
ADM PFIZER BOOSTER,3040034,CDM,771,RC,0003A,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,85,
ADM SARSCOV2 PFIZER  1ST DOSE,3040028,CDM,771,RC,0001A,HCPCS,outpatient,,,55,27.5,,35.75,65,,,percent of total billed charges,65% of total billed charges,37.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.75,65,,,percent of total billed charges,65% of total billed charges,35.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11,85,
ADMIN FLU VAC,3700263,CDM,771,RC,G0008,HCPCS,outpatient,,,28,14,,18.2,65,,,percent of total billed charges,65% of total billed charges,19.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.6,20,,,percent of total billed charges,20% of total billed charges,5.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.6,20,,,percent of total billed charges,20% of total billed charges,5.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.2,65,,,percent of total billed charges,65% of total billed charges,18.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,85,
ADMIN PAT MED,3700269,CDM,260,RC,96372,HCPCS,outpatient,,,38,19,,24.7,65,,,percent of total billed charges,65% of total billed charges,25.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.6,20,,,percent of total billed charges,20% of total billed charges,7.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.6,20,,,percent of total billed charges,20% of total billed charges,7.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.7,65,,,percent of total billed charges,65% of total billed charges,24.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.6,53.67,
ADMIN PNEUMO VAC,3700265,CDM,771,RC,G0009,HCPCS,outpatient,,,28,14,,18.2,65,,,percent of total billed charges,65% of total billed charges,19.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.6,20,,,percent of total billed charges,20% of total billed charges,5.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.6,20,,,percent of total billed charges,20% of total billed charges,5.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.2,65,,,percent of total billed charges,65% of total billed charges,18.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,85,
ADMIN SARSCOV2 MODERNA 1ST DOSE,3040030,CDM,771,RC,0011A,HCPCS,outpatient,,,55,27.5,,35.75,65,,,percent of total billed charges,65% of total billed charges,37.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.75,65,,,percent of total billed charges,65% of total billed charges,35.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11,85,
ADMIN SARSCOV2 MODERNA 2ND DOSE,3040031,CDM,771,RC,0012A,HCPCS,outpatient,,,92,46,,59.8,65,,,percent of total billed charges,65% of total billed charges,62.56,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,65,,,percent of total billed charges,65% of total billed charges,59.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.4,85,
ADMIN SARSCOV2 PFIZER 2ND DOSE,3040029,CDM,771,RC,0002A,HCPCS,outpatient,,,92,46,,59.8,65,,,percent of total billed charges,65% of total billed charges,62.56,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,65,,,percent of total billed charges,65% of total billed charges,59.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.4,85,
ADULT ARMBOARD,3250693,CDM,270,RC,,,outpatient,,,46,23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.2,20,,,percent of total billed charges,20% of total billed charges,9.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.2,20,,,percent of total billed charges,20% of total billed charges,9.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.9,65,,,percent of total billed charges,65% of total billed charges,29.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.2,53.67,
ADULT COLORINDRIC CO2 DETECTOR,3170117,CDM,272,RC,,,outpatient,,,94.44,47.22,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.89,20,,,percent of total billed charges,20% of total billed charges,18.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.89,20,,,percent of total billed charges,20% of total billed charges,18.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.39,65,,,percent of total billed charges,65% of total billed charges,61.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.89,61.39,
ADULT ELECTRODES ONE STEP,3250587,CDM,272,RC,,,outpatient,,,251.6,125.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.32,20,,,percent of total billed charges,20% of total billed charges,50.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.32,20,,,percent of total billed charges,20% of total billed charges,50.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,163.54,65,,,percent of total billed charges,65% of total billed charges,163.54,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.32,163.54,
AEROCHAMBER SPACER,3170065,CDM,272,RC,,,outpatient,,,50.55,25.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.11,20,,,percent of total billed charges,20% of total billed charges,10.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.11,20,,,percent of total billed charges,20% of total billed charges,10.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.86,65,,,percent of total billed charges,65% of total billed charges,32.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,53.67,
AEROCHAMBER Z-STAT,4000012,CDM,270,RC,,,outpatient,,,67.32,33.66,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.46,20,,,percent of total billed charges,20% of total billed charges,13.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.46,20,,,percent of total billed charges,20% of total billed charges,13.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.76,65,,,percent of total billed charges,65% of total billed charges,43.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.46,53.67,
AFB CULTURE,3300699,CDM,306,RC,87116,HCPCS,outpatient,,,79,39.5,,51.35,65,,,percent of total billed charges,65% of total billed charges,53.72,68,,,percent of total billed charges,68% of total billed charges,15.34,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.8,20,,,percent of total billed charges,20% of total billed charges,15.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.8,20,,,percent of total billed charges,20% of total billed charges,15.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.35,65,,,percent of total billed charges,65% of total billed charges,51.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.34,53.72,
AFB SMEAR,3300697,CDM,306,RC,87206,HCPCS,outpatient,,,88,44,,57.2,65,,,percent of total billed charges,65% of total billed charges,59.84,68,,,percent of total billed charges,68% of total billed charges,7.62,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.2,65,,,percent of total billed charges,65% of total billed charges,57.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,59.84,
AFP TUMOR MARKER,3300427,CDM,301,RC,82105,HCPCS,outpatient,,,46,23,,29.9,65,,,percent of total billed charges,65% of total billed charges,31.28,68,,,percent of total billed charges,68% of total billed charges,23.81,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.2,20,,,percent of total billed charges,20% of total billed charges,9.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.2,20,,,percent of total billed charges,20% of total billed charges,9.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.9,65,,,percent of total billed charges,65% of total billed charges,29.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.2,31.28,
AFP-TRIPLE TEST,3300293,CDM,301,RC,82107,HCPCS,outpatient,,,170.5,85.25,,110.83,65,,,percent of total billed charges,65% of total billed charges,115.94,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.1,20,,,percent of total billed charges,20% of total billed charges,34.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.1,20,,,percent of total billed charges,20% of total billed charges,34.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110.83,65,,,percent of total billed charges,65% of total billed charges,110.83,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.1,115.94,
AIRWAY NASAL,3170025,CDM,272,RC,,,outpatient,,,30,15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,53.67,
AIRWAY ORAL,3170027,CDM,272,RC,,,outpatient,,,30,15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,53.67,
ALBUMIN,3300075,CDM,301,RC,82040,HCPCS,outpatient,,,27.5,13.75,,17.88,65,,,percent of total billed charges,65% of total billed charges,18.7,68,,,percent of total billed charges,68% of total billed charges,5.67,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.5,20,,,percent of total billed charges,20% of total billed charges,5.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.5,20,,,percent of total billed charges,20% of total billed charges,5.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.88,65,,,percent of total billed charges,65% of total billed charges,17.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.5,18.7,
ALBUMIN HUMAN 25% INJ - 1,3500990,CDM,250,RC,P9046,HCPCS,outpatient,,,441.7,220.85,,287.11,65,,,percent of total billed charges,65% of total billed charges,300.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.34,20,,,percent of total billed charges,20% of total billed charges,88.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.34,20,,,percent of total billed charges,20% of total billed charges,88.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,287.11,65,,,percent of total billed charges,65% of total billed charges,287.11,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,300.36,
ALBUTEROL LIQ [2 MG/5 ML,3500024,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ALBUTEROL MDI,3500025,CDM,636,RC,J7611,HCPCS,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,3.4,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,80,,,case rate,80% for high cost drug carve out,4.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,4.25,
ALBUTEROL/ IPRATROPIUM MD,3500026,CDM,250,RC,,,outpatient,,,470.85,235.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.17,20,,,percent of total billed charges,20% of total billed charges,94.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.17,20,,,percent of total billed charges,20% of total billed charges,94.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,306.05,65,,,percent of total billed charges,65% of total billed charges,306.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,282.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,306.05,
ALDOLASE,3300291,CDM,301,RC,82085,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,13.78,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,46.24,
ALDOSTERONE,3300303,CDM,301,RC,82088,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,57.84,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,129.2,
ALGICELL WOUND DRESSING,3250663,CDM,272,RC,,,outpatient,,,38.82,19.41,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.76,20,,,percent of total billed charges,20% of total billed charges,7.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.76,20,,,percent of total billed charges,20% of total billed charges,7.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.23,65,,,percent of total billed charges,65% of total billed charges,25.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.76,53.67,
ALGINATE WOUND DRESSING,3250652,CDM,623,RC,A6196,HCPCS,outpatient,,,69.86,34.93,,45.41,65,,,percent of total billed charges,65% of total billed charges,47.5,68,,,percent of total billed charges,68% of total billed charges,7.01,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.97,20,,,percent of total billed charges,20% of total billed charges,13.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.97,20,,,percent of total billed charges,20% of total billed charges,13.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.41,65,,,percent of total billed charges,65% of total billed charges,45.41,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.01,53.67,
ALKALINE PHOSPHATASE,3300083,CDM,301,RC,84075,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,7.34,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
ALKPHOS ISOENZYMES,3300433,CDM,301,RC,84080,HCPCS,outpatient,,,30.6,15.3,,19.89,65,,,percent of total billed charges,65% of total billed charges,20.81,68,,,percent of total billed charges,68% of total billed charges,20.99,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.12,20,,,percent of total billed charges,20% of total billed charges,6.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.12,20,,,percent of total billed charges,20% of total billed charges,6.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.89,65,,,percent of total billed charges,65% of total billed charges,19.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.3,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.12,20.99,
ALLERGEN GRASSES,3300605,CDM,302,RC,86003,HCPCS,outpatient,,,27,13.5,,17.55,65,,,percent of total billed charges,65% of total billed charges,18.36,68,,,percent of total billed charges,68% of total billed charges,7.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,20,,,percent of total billed charges,20% of total billed charges,5.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,20,,,percent of total billed charges,20% of total billed charges,5.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.55,65,,,percent of total billed charges,65% of total billed charges,17.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,18.36,
ALLERGEN PROFILE ZN4,3300625,CDM,302,RC,86003,HCPCS,outpatient,,,402.5,201.25,,261.63,65,,,percent of total billed charges,65% of total billed charges,273.7,68,,,percent of total billed charges,68% of total billed charges,7.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.5,20,,,percent of total billed charges,20% of total billed charges,80.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.5,20,,,percent of total billed charges,20% of total billed charges,80.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261.63,65,,,percent of total billed charges,65% of total billed charges,261.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,201.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.41,273.7,
ALLERGEN TREE,3300603,CDM,302,RC,86003,HCPCS,outpatient,,,27,13.5,,17.55,65,,,percent of total billed charges,65% of total billed charges,18.36,68,,,percent of total billed charges,68% of total billed charges,7.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,20,,,percent of total billed charges,20% of total billed charges,5.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,20,,,percent of total billed charges,20% of total billed charges,5.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.55,65,,,percent of total billed charges,65% of total billed charges,17.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,18.36,
ALLERGY SC MOLD/ANIM,3300607,CDM,302,RC,86005,HCPCS,outpatient,,,71,35.5,,46.15,65,,,percent of total billed charges,65% of total billed charges,48.28,68,,,percent of total billed charges,68% of total billed charges,11.32,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.15,65,,,percent of total billed charges,65% of total billed charges,46.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.32,48.28,
ALLEVYN DRES 4X4 BOX 10,3250634,CDM,272,RC,,,outpatient,,,35.5,17.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.1,20,,,percent of total billed charges,20% of total billed charges,7.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.1,20,,,percent of total billed charges,20% of total billed charges,7.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.08,65,,,percent of total billed charges,65% of total billed charges,23.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.1,53.67,
ALLOPURINOL TAB [100 MG],3500029,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ALLOPURINOL TAB [300 MG],3500030,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ALPRAZOLAM TAB [0.25 MG],3500031,CDM,250,RC,,,outpatient,,,7.75,3.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
ALPRAZOLAM TAB [0.5 MG],3500032,CDM,250,RC,,,outpatient,,,7.75,3.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
ALT,3300115,CDM,301,RC,84460,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,7.52,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
ALTEPLASE INJ [2 MG/2 ML],3500978,CDM,250,RC,J2997,HCPCS,outpatient,,,734.7,367.35,,477.56,65,,,percent of total billed charges,65% of total billed charges,499.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.94,20,,,percent of total billed charges,20% of total billed charges,146.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.94,20,,,percent of total billed charges,20% of total billed charges,146.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,477.56,65,,,percent of total billed charges,65% of total billed charges,477.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,499.6,
ALUMINUM,3300235,CDM,301,RC,82108,HCPCS,outpatient,,,92,46,,59.8,65,,,percent of total billed charges,65% of total billed charges,62.56,68,,,percent of total billed charges,68% of total billed charges,36.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,65,,,percent of total billed charges,65% of total billed charges,59.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.4,62.56,
AMANTADINE CAP [100 MG],3500034,CDM,250,RC,,,outpatient,,,30.3,15.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.06,20,,,percent of total billed charges,20% of total billed charges,6.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.06,20,,,percent of total billed charges,20% of total billed charges,6.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.7,65,,,percent of total billed charges,65% of total billed charges,19.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,53.67,
AMIKACIN,3300181,CDM,301,RC,80150,HCPCS,outpatient,,,95,47.5,,61.75,65,,,percent of total billed charges,65% of total billed charges,64.6,68,,,percent of total billed charges,68% of total billed charges,21.39,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.75,65,,,percent of total billed charges,65% of total billed charges,61.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19,64.6,
AMINO ACIDS QUANTITY,3300319,CDM,301,RC,82131,HCPCS,outpatient,,,72,36,,46.8,65,,,percent of total billed charges,65% of total billed charges,48.96,68,,,percent of total billed charges,68% of total billed charges,6.69,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,65,,,percent of total billed charges,65% of total billed charges,46.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,48.96,
AMINOSYN 3.5 1M,3520013,CDM,258,RC,J0282,HCPCS,outpatient,,,138.45,69.23,,89.99,65,,,percent of total billed charges,65% of total billed charges,94.15,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.69,20,,,percent of total billed charges,20% of total billed charges,27.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.69,20,,,percent of total billed charges,20% of total billed charges,27.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.99,65,,,percent of total billed charges,65% of total billed charges,89.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,94.15,
AMIODARONE,3300239,CDM,301,RC,80299,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,19.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.43,102,
AMIODARONE INJ [50 MG/ ML,3500038,CDM,636,RC,J0282,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
AMIODARONE TAB [200 MG],3500039,CDM,250,RC,,,outpatient,,,39.75,19.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.95,20,,,percent of total billed charges,20% of total billed charges,7.95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.95,20,,,percent of total billed charges,20% of total billed charges,7.95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.84,65,,,percent of total billed charges,65% of total billed charges,25.84,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.95,53.67,
AMITRIPTYLINE,3300341,CDM,301,RC,80152,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,61.2,
AMITRIPTYLINE TAB [10 MG],3500040,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
AMITRIPTYLINE TAB [25 MG],3500041,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
AMLODIPINE 2.5 MG,3500046,CDM,250,RC,,,outpatient,,,8,4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.6,20,,,percent of total billed charges,20% of total billed charges,1.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.6,20,,,percent of total billed charges,20% of total billed charges,1.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,65,,,percent of total billed charges,65% of total billed charges,5.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.6,53.67,
AMLODIPINE TAB [10 MG],3500043,CDM,250,RC,,,outpatient,,,11.3,5.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.26,20,,,percent of total billed charges,20% of total billed charges,2.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.26,20,,,percent of total billed charges,20% of total billed charges,2.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.35,65,,,percent of total billed charges,65% of total billed charges,7.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.26,53.67,
AMLODIPINE TAB [5 MG],3500044,CDM,250,RC,,,outpatient,,,8.25,4.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.65,20,,,percent of total billed charges,20% of total billed charges,1.65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.65,20,,,percent of total billed charges,20% of total billed charges,1.65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.36,65,,,percent of total billed charges,65% of total billed charges,5.36,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,53.67,
AMMON LACTATE 12% [225 GM,3500045,CDM,250,RC,,,outpatient,,,39.65,19.83,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.93,20,,,percent of total billed charges,20% of total billed charges,7.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.93,20,,,percent of total billed charges,20% of total billed charges,7.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.77,65,,,percent of total billed charges,65% of total billed charges,25.77,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.93,53.67,
AMMONIA,3300019,CDM,301,RC,82140,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,20.68,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,61.2,
AMMONIA ARAMATIC IHL,3510651,CDM,250,RC,,,outpatient,,,3.85,1.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.77,20,,,percent of total billed charges,20% of total billed charges,0.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.77,20,,,percent of total billed charges,20% of total billed charges,0.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,65,,,percent of total billed charges,65% of total billed charges,2.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.77,53.67,
AMOXICIL/ POT CLAV SUSP [,3500047,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
AMOXICIL/ POT CLAV SUSP [,3500048,CDM,250,RC,,,outpatient,,,5.05,2.53,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.01,20,,,percent of total billed charges,20% of total billed charges,1.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.01,20,,,percent of total billed charges,20% of total billed charges,1.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.28,65,,,percent of total billed charges,65% of total billed charges,3.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.01,53.67,
AMOXICIL/ POT CLAV SUSP [,3500049,CDM,250,RC,,,outpatient,,,17.6,8.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.52,20,,,percent of total billed charges,20% of total billed charges,3.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.52,20,,,percent of total billed charges,20% of total billed charges,3.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.44,65,,,percent of total billed charges,65% of total billed charges,11.44,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.52,53.67,
AMOXICIL/ POT CLAV TAB [2,3500050,CDM,250,RC,,,outpatient,,,29.6,14.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.92,20,,,percent of total billed charges,20% of total billed charges,5.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.92,20,,,percent of total billed charges,20% of total billed charges,5.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.24,65,,,percent of total billed charges,65% of total billed charges,19.24,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.92,53.67,
AMOXICIL/ POT CLAV TAB [5,3500992,CDM,250,RC,,,outpatient,,,18.95,9.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.79,20,,,percent of total billed charges,20% of total billed charges,3.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.79,20,,,percent of total billed charges,20% of total billed charges,3.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.32,65,,,percent of total billed charges,65% of total billed charges,12.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.79,53.67,
AMOXICIL/ POT CLAV TAB [8,3500051,CDM,250,RC,,,outpatient,,,25.3,12.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.06,20,,,percent of total billed charges,20% of total billed charges,5.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.06,20,,,percent of total billed charges,20% of total billed charges,5.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.45,65,,,percent of total billed charges,65% of total billed charges,16.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.06,53.67,
AMOXICILLIN CAP [500 MG],3500053,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
AMOXICILLIN SUSP [125 MG/,3500054,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
AMOXICILLIN SUSP [250 MG/,3500055,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
AMOXICILLIN SUSP [400 MG/,3500056,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
AMPICILLIN INJ [1 GM],3500058,CDM,636,RC,J0290,HCPCS,outpatient,,,25.9,12.95,,,,,,other,Not reimbursable per contract ,17.61,68,,,case rate,68% of high cost drug carve out,1.86,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.18,20,,,percent of total billed charges,20% of total billed charges,5.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.18,20,,,percent of total billed charges,20% of total billed charges,5.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.72,80,,,case rate,80% for high cost drug carve out,22.02,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.86,22.02,
AMPICILLIN INJ [500 MG],3500059,CDM,636,RC,J0290,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,1.86,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.86,21.25,
AMPICILLIN/ SULB INJ [3 G,3500062,CDM,636,RC,J0295,HCPCS,outpatient,,,65.7,32.85,,,,,,other,Not reimbursable per contract ,44.68,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.14,20,,,percent of total billed charges,20% of total billed charges,13.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.14,20,,,percent of total billed charges,20% of total billed charges,13.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.56,80,,,case rate,80% for high cost drug carve out,55.85,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,55.85,
AMPUTATION FOOT TRANSMETARSAL,3462061,CDM,982,RC,28805,HCPCS,outpatient,,,1002,501,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,502.76,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,795.42,110,,,fee schedule,110% of Medicare physician fee schedule,795.42,110,,,fee schedule,110% of Medicare physician fee schedule,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,831.58,115,,,fee schedule,115% of Medicare physician fee schedule,555.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,502.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,914.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,502.76,914.73,
AMPUTATION LEG THRU TIBIAFIBULA,3462060,CDM,982,RC,27880,HCPCS,outpatient,,,1292,646,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,641.23,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,1039.68,110,,,fee schedule,110% of Medicare physician fee schedule,1039.68,110,,,fee schedule,110% of Medicare physician fee schedule,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,1086.93,115,,,fee schedule,115% of Medicare physician fee schedule,693.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,641.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1195.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,641.23,1195.63,
AMPUTATION METATARSAL W/TOE SINGLE,3462062,CDM,982,RC,28810,HCPCS,outpatient,,,594,297,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,300.94,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.66,110,,,fee schedule,110% of Medicare physician fee schedule,474.66,110,,,fee schedule,110% of Medicare physician fee schedule,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,496.24,115,,,fee schedule,115% of Medicare physician fee schedule,353.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,545.86,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.94,545.86,
AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,3462059,CDM,982,RC,27590,HCPCS,outpatient,,,1130,565,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,561.08,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,907.81,110,,,fee schedule,110% of Medicare physician fee schedule,907.81,110,,,fee schedule,110% of Medicare physician fee schedule,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,949.07,115,,,fee schedule,115% of Medicare physician fee schedule,613.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,561.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1043.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,561.08,1043.98,
AMPUTATION TOE INTERPHALANGEAL JOINT,3462085,CDM,982,RC,28825,HCPCS,outpatient,,,716,358,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,207.6,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,193.91,110,,,fee schedule,110% of Medicare physician fee schedule,193.91,110,,,fee schedule,110% of Medicare physician fee schedule,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,202.72,115,,,fee schedule,115% of Medicare physician fee schedule,260.2,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.91,260.2,
AMPUTATION TOE METATARSOPHALANGEAL JOINT,3462084,CDM,982,RC,28820,HCPCS,outpatient,,,751,375.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,221.51,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,200.85,110,,,fee schedule,110% of Medicare physician fee schedule,200.85,110,,,fee schedule,110% of Medicare physician fee schedule,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.98,115,,,fee schedule,115% of Medicare physician fee schedule,274.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,200.85,274.11,
AMYLASE,3300031,CDM,301,RC,82150,HCPCS,outpatient,,,27.5,13.75,,17.88,65,,,percent of total billed charges,65% of total billed charges,18.7,68,,,percent of total billed charges,68% of total billed charges,9.2,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.5,20,,,percent of total billed charges,20% of total billed charges,5.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.5,20,,,percent of total billed charges,20% of total billed charges,5.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.88,65,,,percent of total billed charges,65% of total billed charges,17.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.5,18.7,
ANA ANTINUCLR ANTBDY,3300477,CDM,302,RC,86038,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,17.15,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,40.8,
ANASEPT,3521943,CDM,271,RC,,,outpatient,,,102.41,51.21,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.48,20,,,percent of total billed charges,20% of total billed charges,20.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.48,20,,,percent of total billed charges,20% of total billed charges,20.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.57,65,,,percent of total billed charges,65% of total billed charges,66.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.48,66.57,
ANES COMBINED UPPER-LOWER GI PX (CRNA),3220162,CDM,964,RC,813,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,235,,,,fee schedule,110% of Medicare physician fee schedule,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,125.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.48,235,
ANES COMBINED UPPER-LOWER GI PX (FAC),3220160,CDM,370,RC,,,outpatient,,,800,400,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,65,,,percent of total billed charges,65% of total billed charges,520,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,520,
ANES HEAD/NECK/PTRUNK,3220272,CDM,964,RC,300,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,235,,,,fee schedule,110% of Medicare physician fee schedule,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,125.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.48,235,
ANES LOWER INST ENDO DIAGNOSTIC (CRNA),3220164,CDM,964,RC,811,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,188,,,,fee schedule,110% of Medicare physician fee schedule,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,125.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.5,188,
ANES LOWER INTST ENDO DIAGNOSTIC (FAC),3220163,CDM,370,RC,811,HCPCS,outpatient,,,800,400,,520,65,,,percent of total billed charges,65% of total billed charges,544,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,65,,,percent of total billed charges,65% of total billed charges,520,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,544,
ANESTH ANORECTAL SURGERY,3220268,CDM,964,RC,902,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,235,,,,fee schedule,110% of Medicare physician fee schedule,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,125.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.5,235,
ANESTH GENITALIA SURGERY,3220274,CDM,964,RC,920,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,43.49,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,141,,,,fee schedule,110% of Medicare physician fee schedule,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,96.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,43.49,141,
ANESTH REPAIR OF HERNIA,3220264,CDM,964,RC,832,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,86.99,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,282,,,,fee schedule,110% of Medicare physician fee schedule,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,139.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,264,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.99,282,
ANESTH RPR OF HERNIA LOWER ABD NON SPEC,3220270,CDM,964,RC,830,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57.99,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,188,,,,fee schedule,110% of Medicare physician fee schedule,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,110.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.99,188,
ANESTH SKIN EXT/PER/ATRUNK,3220273,CDM,964,RC,400,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,43.49,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,141,,,,fee schedule,110% of Medicare physician fee schedule,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,96.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,43.49,141,
ANESTH SURG UPPER ABDOMEN,3220266,CDM,964,RC,790,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,101.48,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,329,,,,fee schedule,110% of Medicare physician fee schedule,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,154.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,308,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,329,
ANESTH UPPER LEG SURGERY,3220275,CDM,964,RC,1250,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57.99,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,188,,,,fee schedule,110% of Medicare physician fee schedule,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,110.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.99,188,
ANGIOTENSIN CON ENZM,3300279,CDM,301,RC,82164,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,20.72,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
ANITBODY ELUTION,3300597,CDM,309,RC,86860,HCPCS,outpatient,,,99,49.5,,64.35,65,,,percent of total billed charges,65% of total billed charges,67.32,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,20,,,percent of total billed charges,20% of total billed charges,19.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,20,,,percent of total billed charges,20% of total billed charges,19.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.35,65,,,percent of total billed charges,65% of total billed charges,64.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,67.32,
ANITBODY IDENTIFY,3300795,CDM,309,RC,86870,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,129.2,
ANKLE 3 VIEWS  L,3440011,CDM,972,RC,73610,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,217.85,115,,,fee schedule,115% of Medicare physician fee schedule,69.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,217.85,
ANKLE 3 VIEWS BIL,3440009,CDM,972,RC,73610,HCPCS,outpatient,,,82.5,41.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,217.85,115,,,fee schedule,115% of Medicare physician fee schedule,69.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,217.85,
ANKLE 3 VIEWS RT,3440013,CDM,972,RC,73610,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,217.85,115,,,fee schedule,115% of Medicare physician fee schedule,69.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,217.85,
ANKLE 3 VIEWS-BI,3400065,CDM,320,RC,73610,HCPCS,outpatient,,,176,88,,114.4,65,,,percent of total billed charges,65% of total billed charges,119.68,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.2,20,,,percent of total billed charges,20% of total billed charges,35.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.2,20,,,percent of total billed charges,20% of total billed charges,35.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.4,65,,,percent of total billed charges,65% of total billed charges,114.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
ANKLE 3 VIEWS-L,3400002,CDM,320,RC,73610,HCPCS,outpatient,,,126.5,63.25,,82.23,65,,,percent of total billed charges,65% of total billed charges,86.02,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.23,65,,,percent of total billed charges,65% of total billed charges,82.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
ANKLE 3 VIEWS-R,3400064,CDM,320,RC,73610,HCPCS,outpatient,,,126.5,63.25,,82.23,65,,,percent of total billed charges,65% of total billed charges,86.02,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.23,65,,,percent of total billed charges,65% of total billed charges,82.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
ANKLE BIL 2 VIEW,3400113,CDM,320,RC,73600,HCPCS,outpatient,,,174,87,,113.1,65,,,percent of total billed charges,65% of total billed charges,118.32,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,20,,,percent of total billed charges,20% of total billed charges,34.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,20,,,percent of total billed charges,20% of total billed charges,34.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.1,65,,,percent of total billed charges,65% of total billed charges,113.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
ANKLE BIL 2 VIEW,3440361,CDM,972,RC,73600,HCPCS,outpatient,,,56.1,28.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.07,110,,,fee schedule,110% of Medicare physician fee schedule,35.07,110,,,fee schedule,110% of Medicare physician fee schedule,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.06,115,,,fee schedule,115% of Medicare physician fee schedule,68.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.31,213.06,
ANKLE LT 2 VIEW,3400115,CDM,320,RC,73600,HCPCS,outpatient,,,168.3,84.15,,109.4,65,,,percent of total billed charges,65% of total billed charges,114.44,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.66,20,,,percent of total billed charges,20% of total billed charges,33.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.66,20,,,percent of total billed charges,20% of total billed charges,33.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.4,65,,,percent of total billed charges,65% of total billed charges,109.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
ANKLE LT 2 VIEW,3440365,CDM,972,RC,73600,HCPCS,outpatient,,,44,22,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.07,110,,,fee schedule,110% of Medicare physician fee schedule,35.07,110,,,fee schedule,110% of Medicare physician fee schedule,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.06,115,,,fee schedule,115% of Medicare physician fee schedule,68.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.31,213.06,
ANKLE RT 2 VIEW,3400114,CDM,320,RC,73600,HCPCS,outpatient,,,168.3,84.15,,109.4,65,,,percent of total billed charges,65% of total billed charges,114.44,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.66,20,,,percent of total billed charges,20% of total billed charges,33.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.66,20,,,percent of total billed charges,20% of total billed charges,33.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.4,65,,,percent of total billed charges,65% of total billed charges,109.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
ANKLE RT 2 VIEW,3440363,CDM,972,RC,73600,HCPCS,outpatient,,,44,22,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.07,110,,,fee schedule,110% of Medicare physician fee schedule,35.07,110,,,fee schedule,110% of Medicare physician fee schedule,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.06,115,,,fee schedule,115% of Medicare physician fee schedule,68.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.31,213.06,
ANTGN/SPECIAL TYPING,3300799,CDM,309,RC,86902,HCPCS,outpatient,,,93,46.5,,60.45,65,,,percent of total billed charges,65% of total billed charges,63.24,68,,,percent of total billed charges,68% of total billed charges,8.37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.45,65,,,percent of total billed charges,65% of total billed charges,60.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.37,63.24,
ANTI SMITH,3300577,CDM,302,RC,86235,HCPCS,outpatient,,,112,56,,72.8,65,,,percent of total billed charges,65% of total billed charges,76.16,68,,,percent of total billed charges,68% of total billed charges,25.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.8,65,,,percent of total billed charges,65% of total billed charges,72.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,76.16,
ANTI-CCP,3300932,CDM,300,RC,86200,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,61.2,
ANTI-DIURETIC HORMONE,3300050,CDM,301,RC,84588,HCPCS,outpatient,,,168,84,,109.2,65,,,percent of total billed charges,65% of total billed charges,114.24,68,,,percent of total billed charges,68% of total billed charges,48.18,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.2,65,,,percent of total billed charges,65% of total billed charges,109.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,114.24,
ANTI-SCL-70,3300935,CDM,300,RC,86235,HCPCS,outpatient,,,12.83,6.42,,8.34,65,,,percent of total billed charges,65% of total billed charges,8.72,68,,,percent of total billed charges,68% of total billed charges,25.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.57,20,,,percent of total billed charges,20% of total billed charges,2.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.57,20,,,percent of total billed charges,20% of total billed charges,2.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.34,65,,,percent of total billed charges,65% of total billed charges,8.34,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.42,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.57,25.45,
"ANTI-THYROGLOBULIN, AB",3300913,CDM,302,RC,86376,HCPCS,outpatient,,,185,92.5,,120.25,65,,,percent of total billed charges,65% of total billed charges,125.8,68,,,percent of total billed charges,68% of total billed charges,20.65,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,20,,,percent of total billed charges,20% of total billed charges,37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,20,,,percent of total billed charges,20% of total billed charges,37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.25,65,,,percent of total billed charges,65% of total billed charges,120.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.65,125.8,
ANTIBODY SCREEN,3300785,CDM,309,RC,86885,HCPCS,outpatient,,,93,46.5,,60.45,65,,,percent of total billed charges,65% of total billed charges,63.24,68,,,percent of total billed charges,68% of total billed charges,8.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.45,65,,,percent of total billed charges,65% of total billed charges,60.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.12,63.24,
ANTICARDIOLIPIN,3300507,CDM,302,RC,86147,HCPCS,outpatient,,,189,94.5,,122.85,65,,,percent of total billed charges,65% of total billed charges,128.52,68,,,percent of total billed charges,68% of total billed charges,22.87,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,20,,,percent of total billed charges,20% of total billed charges,37.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,20,,,percent of total billed charges,20% of total billed charges,37.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.85,65,,,percent of total billed charges,65% of total billed charges,122.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.87,128.52,
ANTIDIURETIC HORMONE,3300343,CDM,301,RC,84588,HCPCS,outpatient,,,165,82.5,,107.25,65,,,percent of total billed charges,65% of total billed charges,112.2,68,,,percent of total billed charges,68% of total billed charges,48.18,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.25,65,,,percent of total billed charges,65% of total billed charges,107.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,112.2,
ANTITHROMBIN III AB,3300665,CDM,305,RC,85301,HCPCS,outpatient,,,168,84,,109.2,65,,,percent of total billed charges,65% of total billed charges,114.24,68,,,percent of total billed charges,68% of total billed charges,15.35,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.2,65,,,percent of total billed charges,65% of total billed charges,109.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.35,114.24,
ANTITHROMBIN III ACT,3300663,CDM,305,RC,85300,HCPCS,outpatient,,,168,84,,109.2,65,,,percent of total billed charges,65% of total billed charges,114.24,68,,,percent of total billed charges,68% of total billed charges,8.03,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.2,65,,,percent of total billed charges,65% of total billed charges,109.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,114.24,
ANTITRYPSIN ALPA 1,3300473,CDM,301,RC,82103,HCPCS,outpatient,,,54,27,,35.1,65,,,percent of total billed charges,65% of total billed charges,36.72,68,,,percent of total billed charges,68% of total billed charges,19.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.1,65,,,percent of total billed charges,65% of total billed charges,35.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,36.72,
APICAL LORDOTIC CHES,3400128,CDM,324,RC,71021,HCPCS,outpatient,,,222,111,,144.3,65,,,percent of total billed charges,65% of total billed charges,150.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,20,,,percent of total billed charges,20% of total billed charges,44.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,20,,,percent of total billed charges,20% of total billed charges,44.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,144.3,65,,,percent of total billed charges,65% of total billed charges,144.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,133.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,180,
APICAL LORDOTIC CHEST,3440389,CDM,972,RC,71021,HCPCS,outpatient,,,73,36.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,176.4,100,,,case rate,100% of case rate fee,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,176.4,
APIXABAN 5 MG TAB,3501155,CDM,250,RC,,,outpatient,,,47.1,23.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.42,20,,,percent of total billed charges,20% of total billed charges,9.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.42,20,,,percent of total billed charges,20% of total billed charges,9.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.62,65,,,percent of total billed charges,65% of total billed charges,30.62,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.42,53.67,
APIXABAN TAB [2.5 MG],3501151,CDM,250,RC,,,outpatient,,,47.1,23.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.42,20,,,percent of total billed charges,20% of total billed charges,9.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.42,20,,,percent of total billed charges,20% of total billed charges,9.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.62,65,,,percent of total billed charges,65% of total billed charges,30.62,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.42,53.67,
APOLIPOPROTEIN EGENO,3300359,CDM,301,RC,82172,HCPCS,outpatient,,,294,147,,191.1,65,,,percent of total billed charges,65% of total billed charges,199.92,68,,,percent of total billed charges,68% of total billed charges,19.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,20,,,percent of total billed charges,20% of total billed charges,58.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,20,,,percent of total billed charges,20% of total billed charges,58.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,191.1,65,,,percent of total billed charges,65% of total billed charges,191.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,176.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.58,199.92,
APP SPLINT FINGER,3231063,CDM,450,RC,29131,HCPCS,outpatient,,,136,68,,88.4,65,,,percent of total billed charges,65% of total billed charges,92.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.2,20,,,percent of total billed charges,20% of total billed charges,27.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.2,20,,,percent of total billed charges,20% of total billed charges,27.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.4,65,,,percent of total billed charges,65% of total billed charges,88.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.2,178,
APP SPLINT POSTERIO,3231145,CDM,271,RC,,,outpatient,,,220,110,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44,143,
APP SPLINT SHORT ARM,3231061,CDM,450,RC,29125,HCPCS,outpatient,,,136,68,,88.4,65,,,percent of total billed charges,65% of total billed charges,92.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.2,20,,,percent of total billed charges,20% of total billed charges,27.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.2,20,,,percent of total billed charges,20% of total billed charges,27.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.4,65,,,percent of total billed charges,65% of total billed charges,88.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.2,178,
APP SPLINT SHORT LEG,3231067,CDM,450,RC,29515,HCPCS,outpatient,,,130,65,,84.5,65,,,percent of total billed charges,65% of total billed charges,88.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,20,,,percent of total billed charges,20% of total billed charges,26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,20,,,percent of total billed charges,20% of total billed charges,26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.5,65,,,percent of total billed charges,65% of total billed charges,84.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26,178,
APPENDEC INDICATED PURPOSE OTH MAJOR PX,3462035,CDM,982,RC,44955,HCPCS,outpatient,,,120,60,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,59.04,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,96.79,110,,,fee schedule,110% of Medicare physician fee schedule,96.79,110,,,fee schedule,110% of Medicare physician fee schedule,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.19,115,,,fee schedule,115% of Medicare physician fee schedule,111.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.04,111.64,
APPENDECTOMY,3462034,CDM,982,RC,44950,HCPCS,outpatient,,,918,459,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,460.29,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,745.38,110,,,fee schedule,110% of Medicare physician fee schedule,745.38,110,,,fee schedule,110% of Medicare physician fee schedule,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,779.26,115,,,fee schedule,115% of Medicare physician fee schedule,512.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,460.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,857.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,460.29,857.19,
APPENDECTOMY RPTD APPEN ABSC/PRITONITIS,3462036,CDM,982,RC,44960,HCPCS,outpatient,,,1255,627.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,629.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,1018.39,110,,,fee schedule,110% of Medicare physician fee schedule,1018.39,110,,,fee schedule,110% of Medicare physician fee schedule,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,1064.68,115,,,fee schedule,115% of Medicare physician fee schedule,682.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1171.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.72,1171.15,
APPL SPLINT LONG ARM,3231059,CDM,450,RC,29105,HCPCS,outpatient,,,149,74.5,,96.85,65,,,percent of total billed charges,65% of total billed charges,101.32,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.8,20,,,percent of total billed charges,20% of total billed charges,29.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.8,20,,,percent of total billed charges,20% of total billed charges,29.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.85,65,,,percent of total billed charges,65% of total billed charges,96.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.8,178,
APPL SPLINT LONG LEG,3231065,CDM,450,RC,29505,HCPCS,outpatient,,,141,70.5,,91.65,65,,,percent of total billed charges,65% of total billed charges,95.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,20,,,percent of total billed charges,20% of total billed charges,28.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,20,,,percent of total billed charges,20% of total billed charges,28.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.65,65,,,percent of total billed charges,65% of total billed charges,91.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,178,
APPLICATION  UNA BOOT,3231147,CDM,450,RC,29580,HCPCS,outpatient,,,108,54,,70.2,65,,,percent of total billed charges,65% of total billed charges,73.44,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.6,20,,,percent of total billed charges,20% of total billed charges,21.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.6,20,,,percent of total billed charges,20% of total billed charges,21.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.2,65,,,percent of total billed charges,65% of total billed charges,70.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,178,
APPLICATION RIGID TOTAL CONTACT LEG CAST,3462066,CDM,982,RC,29445,HCPCS,outpatient,,,176,88,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.15,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,109.56,110,,,fee schedule,110% of Medicare physician fee schedule,109.56,110,,,fee schedule,110% of Medicare physician fee schedule,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.54,115,,,fee schedule,115% of Medicare physician fee schedule,119.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.15,125.99,
APPLICATOR COTTON ST,3250479,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
APPLY COMPRES BELOW KNEE/FOOT,3700062,CDM,510,RC,29581,HCPCS,outpatient,,,270,135,,175.5,65,,,percent of total billed charges,65% of total billed charges,183.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,20,,,percent of total billed charges,20% of total billed charges,54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,20,,,percent of total billed charges,20% of total billed charges,54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,175.5,65,,,percent of total billed charges,65% of total billed charges,175.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,183.6,
APPLY MTLLAYR COMPRES LEG BELOW KNEE,3462068,CDM,982,RC,29581,HCPCS,outpatient,,,285,142.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.46,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.21,110,,,fee schedule,110% of Medicare physician fee schedule,29.21,110,,,fee schedule,110% of Medicare physician fee schedule,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.53,115,,,fee schedule,115% of Medicare physician fee schedule,71.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.46,71.06,
APPLY MULTILAYER  COMP LOWER LEG PF,3700064,CDM,983,RC,29581,HCPCS,outpatient,,,134,67,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.46,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.21,110,,,fee schedule,110% of Medicare physician fee schedule,29.21,110,,,fee schedule,110% of Medicare physician fee schedule,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.53,115,,,fee schedule,115% of Medicare physician fee schedule,71.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.46,71.06,
APPLY UNNA BOOT,3700293,CDM,510,RC,29580,HCPCS,outpatient,,,160,80,,104,65,,,percent of total billed charges,65% of total billed charges,108.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104,65,,,percent of total billed charges,65% of total billed charges,104,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32,178,
APPLY UNNA BOOT PRO FEE,3700294,CDM,983,RC,29580,HCPCS,outpatient,,,104,52,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.89,110,,,fee schedule,110% of Medicare physician fee schedule,29.89,110,,,fee schedule,110% of Medicare physician fee schedule,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.25,115,,,fee schedule,115% of Medicare physician fee schedule,70.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.95,70.55,
ARSENIC,3300133,CDM,301,RC,82175,HCPCS,outpatient,,,135,67.5,,87.75,65,,,percent of total billed charges,65% of total billed charges,91.8,68,,,percent of total billed charges,68% of total billed charges,26.93,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,20,,,percent of total billed charges,20% of total billed charges,27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,20,,,percent of total billed charges,20% of total billed charges,27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.75,65,,,percent of total billed charges,65% of total billed charges,87.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.93,91.8,
ART CATH KIT 22X5,6215876,CDM,272,RC,,,outpatient,,,212.8,106.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.56,20,,,percent of total billed charges,20% of total billed charges,42.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.56,20,,,percent of total billed charges,20% of total billed charges,42.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.32,65,,,percent of total billed charges,65% of total billed charges,138.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.56,138.32,
ART/ASP/IN INT JOINT,3231073,CDM,450,RC,20605,HCPCS,outpatient,,,202,101,,131.3,65,,,percent of total billed charges,65% of total billed charges,137.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.4,20,,,percent of total billed charges,20% of total billed charges,40.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.4,20,,,percent of total billed charges,20% of total billed charges,40.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,131.3,65,,,percent of total billed charges,65% of total billed charges,131.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.4,178,
ART/ASP/IN MAJ JOINT,3231161,CDM,450,RC,20610,HCPCS,outpatient,,,202,101,,131.3,65,,,percent of total billed charges,65% of total billed charges,137.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.4,20,,,percent of total billed charges,20% of total billed charges,40.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.4,20,,,percent of total billed charges,20% of total billed charges,40.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,131.3,65,,,percent of total billed charges,65% of total billed charges,131.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.4,178,
ART/ASP/INJ SM JOINT,3231071,CDM,450,RC,20600,HCPCS,outpatient,,,202,101,,131.3,65,,,percent of total billed charges,65% of total billed charges,137.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.4,20,,,percent of total billed charges,20% of total billed charges,40.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.4,20,,,percent of total billed charges,20% of total billed charges,40.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,131.3,65,,,percent of total billed charges,65% of total billed charges,131.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.4,178,
ASO,3300479,CDM,302,RC,86060,HCPCS,outpatient,,,65,32.5,,42.25,65,,,percent of total billed charges,65% of total billed charges,44.2,68,,,percent of total billed charges,68% of total billed charges,10.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,20,,,percent of total billed charges,20% of total billed charges,13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,20,,,percent of total billed charges,20% of total billed charges,13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.25,65,,,percent of total billed charges,65% of total billed charges,42.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.36,44.2,
ASPIRIN CHEW TAB [81 MG],3500069,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
ASPIRIN EC TAB [325 MG],3500070,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
ASPIRIN EC TAB [81 MG],3500071,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
ASPIRIN SUPP [300 MG],3500072,CDM,250,RC,,,outpatient,,,12.7,6.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.54,20,,,percent of total billed charges,20% of total billed charges,2.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.54,20,,,percent of total billed charges,20% of total billed charges,2.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.26,65,,,percent of total billed charges,65% of total billed charges,8.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.54,53.67,
ASPIRIN SUPP [600 MG],3500073,CDM,250,RC,,,outpatient,,,13.15,6.58,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.63,20,,,percent of total billed charges,20% of total billed charges,2.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.63,20,,,percent of total billed charges,20% of total billed charges,2.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.55,65,,,percent of total billed charges,65% of total billed charges,8.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.63,53.67,
ASPIRIN TAB [325 MG],3500074,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
AST,3300069,CDM,301,RC,84450,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,7.33,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
ATENOLOL TAB [25 MG],3500075,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ATENOLOL TAB [50 MG],3500076,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
"ATOMIZER, NASAL",2000307,CDM,271,RC,,,outpatient,,,83.85,41.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.77,20,,,percent of total billed charges,20% of total billed charges,16.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.77,20,,,percent of total billed charges,20% of total billed charges,16.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.5,65,,,percent of total billed charges,65% of total billed charges,54.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.77,54.5,
ATORVASTATIN TAB [10 MG],3501026,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ATORVASTATIN TAB [20 MG],3501027,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ATORVASTATIN TAB [40 MG],3501028,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ATROPINE [1%] DRP [EYE],3500077,CDM,250,RC,,,outpatient,,,89.2,44.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.84,20,,,percent of total billed charges,20% of total billed charges,17.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.84,20,,,percent of total billed charges,20% of total billed charges,17.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.98,65,,,percent of total billed charges,65% of total billed charges,57.98,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.84,57.98,
ATROPINE INJ SYR [1 MG/10,3500081,CDM,636,RC,J0461,HCPCS,outpatient,,,29.8,14.9,,,,,,other,Not reimbursable per contract ,20.26,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.96,20,,,percent of total billed charges,20% of total billed charges,5.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.96,20,,,percent of total billed charges,20% of total billed charges,5.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.84,80,,,case rate,80% for high cost drug carve out,25.33,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.96,25.33,
AVELOX/NS PREMIX [400 MG/,3500973,CDM,250,RC,,,outpatient,,,226.4,113.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.28,20,,,percent of total billed charges,20% of total billed charges,45.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.28,20,,,percent of total billed charges,20% of total billed charges,45.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147.16,65,,,percent of total billed charges,65% of total billed charges,147.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.28,147.16,
AVULSION NAIL PLATE PART/COMP SIMP 1,3462082,CDM,982,RC,11730,HCPCS,outpatient,,,185,92.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.96,110,,,fee schedule,110% of Medicare physician fee schedule,59.96,110,,,fee schedule,110% of Medicare physician fee schedule,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.69,115,,,fee schedule,115% of Medicare physician fee schedule,88.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.22,88.82,
AVULSION NAIL PLATE PART/COMP SIMP ADDL,3060411,CDM,360,RC,11732,HCPCS,outpatient,,,120,60,,78,65,,,percent of total billed charges,65% of total billed charges,81.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,65,,,percent of total billed charges,65% of total billed charges,78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,178,
AVULSION NAIL PLATE PART/COMP SIMP ADDL,3462083,CDM,982,RC,11732,HCPCS,outpatient,,,56,28,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.77,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.48,110,,,fee schedule,110% of Medicare physician fee schedule,19.48,110,,,fee schedule,110% of Medicare physician fee schedule,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.37,115,,,fee schedule,115% of Medicare physician fee schedule,64.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.77,64.37,
AVULSION NAIL PLATE PART/COMP SIMP PF,3700076,CDM,983,RC,11732,HCPCS,outpatient,,,65,32.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.77,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.48,110,,,fee schedule,110% of Medicare physician fee schedule,19.48,110,,,fee schedule,110% of Medicare physician fee schedule,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.37,115,,,fee schedule,115% of Medicare physician fee schedule,64.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.77,64.37,
AVULSION NAIL PLATE PART/COMPLETE SIMPLE,3060410,CDM,360,RC,11730,HCPCS,outpatient,,,381.35,190.68,,247.88,65,,,percent of total billed charges,65% of total billed charges,259.32,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.27,20,,,percent of total billed charges,20% of total billed charges,76.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.27,20,,,percent of total billed charges,20% of total billed charges,76.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,247.88,65,,,percent of total billed charges,65% of total billed charges,247.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,259.32,
AVULSION NAIL PLATE SIMPLE,3700309,CDM,510,RC,11730,HCPCS,outpatient,,,201,100.5,,130.65,65,,,percent of total billed charges,65% of total billed charges,136.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,20,,,percent of total billed charges,20% of total billed charges,40.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,20,,,percent of total billed charges,20% of total billed charges,40.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.65,65,,,percent of total billed charges,65% of total billed charges,130.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,178,
AZITHROMYCIN INJ [500 MG],3500083,CDM,636,RC,J0456,HCPCS,outpatient,,,32.4,16.2,,,,,,other,Not reimbursable per contract ,22.03,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.48,20,,,percent of total billed charges,20% of total billed charges,6.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.48,20,,,percent of total billed charges,20% of total billed charges,6.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.92,80,,,case rate,80% for high cost drug carve out,27.54,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,27.54,
AZITHROMYCIN SUSP [200 MG,3500085,CDM,250,RC,,,outpatient,,,11.65,5.83,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.33,20,,,percent of total billed charges,20% of total billed charges,2.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.33,20,,,percent of total billed charges,20% of total billed charges,2.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.57,65,,,percent of total billed charges,65% of total billed charges,7.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.33,53.67,
AZITHROMYCIN TAB [250 MG],3500086,CDM,250,RC,,,outpatient,,,7.45,3.73,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.49,20,,,percent of total billed charges,20% of total billed charges,1.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.49,20,,,percent of total billed charges,20% of total billed charges,1.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.84,65,,,percent of total billed charges,65% of total billed charges,4.84,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.49,53.67,
AZITHROMYCIN TAB [500 MG],3500087,CDM,250,RC,,,outpatient,,,77.85,38.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.57,20,,,percent of total billed charges,20% of total billed charges,15.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.57,20,,,percent of total billed charges,20% of total billed charges,15.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.6,65,,,percent of total billed charges,65% of total billed charges,50.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,53.67,
B-6,3300227,CDM,301,RC,84207,HCPCS,outpatient,,,230,115,,149.5,65,,,percent of total billed charges,65% of total billed charges,156.4,68,,,percent of total billed charges,68% of total billed charges,25.72,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46,20,,,percent of total billed charges,20% of total billed charges,46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46,20,,,percent of total billed charges,20% of total billed charges,46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,149.5,65,,,percent of total billed charges,65% of total billed charges,149.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.72,156.4,
"B-TYPE NATRI-PEP, SENDOUT",3300452,CDM,301,RC,83880,HCPCS,outpatient,,,238,119,,154.7,65,,,percent of total billed charges,65% of total billed charges,161.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.6,20,,,percent of total billed charges,20% of total billed charges,47.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.6,20,,,percent of total billed charges,20% of total billed charges,47.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,154.7,65,,,percent of total billed charges,65% of total billed charges,154.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.6,161.84,
B-TYPE NATRIURETIC P,3300451,CDM,301,RC,83880,HCPCS,outpatient,,,175,87.5,,113.75,65,,,percent of total billed charges,65% of total billed charges,119,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.75,65,,,percent of total billed charges,65% of total billed charges,113.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35,119,
B12 VITAMIN,3300307,CDM,301,RC,82607,HCPCS,outpatient,,,70,35,,45.5,65,,,percent of total billed charges,65% of total billed charges,47.6,68,,,percent of total billed charges,68% of total billed charges,21.39,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,65,,,percent of total billed charges,65% of total billed charges,45.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,47.6,
BACITRA EYE OINT [500 U/G,3500089,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
BACITRACIN TOP OINT [500U,3500090,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
BACITRACIN/POLYMIX OINT E,3500091,CDM,250,RC,,,outpatient,,,40.95,20.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.19,20,,,percent of total billed charges,20% of total billed charges,8.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.19,20,,,percent of total billed charges,20% of total billed charges,8.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.62,65,,,percent of total billed charges,65% of total billed charges,26.62,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,53.67,
BACLOFEN TAB [10 MG],3500092,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
BACT CULT:QUAN AEROBIC,3300875,CDM,306,RC,87071,HCPCS,outpatient,,,15,7.5,,9.75,65,,,percent of total billed charges,65% of total billed charges,10.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,10.2,
BAG MASK VENTILATION -ADULT,3170049,CDM,272,RC,,,outpatient,,,104.6,52.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.92,20,,,percent of total billed charges,20% of total billed charges,20.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.92,20,,,percent of total billed charges,20% of total billed charges,20.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.99,65,,,percent of total billed charges,65% of total billed charges,67.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.92,67.99,
BAIR HUGGER LOWER,6215780,CDM,272,RC,,,outpatient,,,57.95,28.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.59,20,,,percent of total billed charges,20% of total billed charges,11.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.59,20,,,percent of total billed charges,20% of total billed charges,11.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.67,65,,,percent of total billed charges,65% of total billed charges,37.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.59,53.67,
BAIR HUGGER UPPER,6215781,CDM,272,RC,,,outpatient,,,87.53,43.77,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.51,20,,,percent of total billed charges,20% of total billed charges,17.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.51,20,,,percent of total billed charges,20% of total billed charges,17.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.89,65,,,percent of total billed charges,65% of total billed charges,56.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.51,56.89,
BALLOON DILATORS,3060049,CDM,272,RC,,,outpatient,,,650,325,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,20,,,percent of total billed charges,20% of total billed charges,130,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,20,,,percent of total billed charges,20% of total billed charges,130,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,422.5,65,,,percent of total billed charges,65% of total billed charges,422.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,422.5,
BALMEX-ZINC OXIDE 11.3%,3501143,CDM,250,RC,,,outpatient,,,13.4,6.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.68,20,,,percent of total billed charges,20% of total billed charges,2.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.68,20,,,percent of total billed charges,20% of total billed charges,2.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.71,65,,,percent of total billed charges,65% of total billed charges,8.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.68,53.67,
BANDAGE 2X4 1/2,3250473,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
BARIUM ENEMA,3400054,CDM,320,RC,74270,HCPCS,outpatient,,,402,201,,261.3,65,,,percent of total billed charges,65% of total billed charges,273.36,68,,,percent of total billed charges,68% of total billed charges,57.03,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.4,20,,,percent of total billed charges,20% of total billed charges,80.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.4,20,,,percent of total billed charges,20% of total billed charges,80.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261.3,65,,,percent of total billed charges,65% of total billed charges,261.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,273.36,
BARIUM ENEMA,3440017,CDM,972,RC,74270,HCPCS,outpatient,,,143,71.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,157.3,110,,,fee schedule,110% of Medicare physician fee schedule,157.3,110,,,fee schedule,110% of Medicare physician fee schedule,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,340.85,115,,,fee schedule,115% of Medicare physician fee schedule,134.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,180.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.1,340.85,
BARIUM/BOTTLE 50ML,3420003,CDM,250,RC,,,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,65,,,percent of total billed charges,65% of total billed charges,10.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.2,53.67,
"BARRIER, FLANG  1 1/4",3250687,CDM,272,RC,,,outpatient,,,20,10,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,53.67,
BARTONELLA HENSELAE AB. IgG,3300926,CDM,301,RC,86611,HCPCS,outpatient,,,74.5,37.25,,48.43,65,,,percent of total billed charges,65% of total billed charges,50.66,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.9,20,,,percent of total billed charges,20% of total billed charges,14.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.9,20,,,percent of total billed charges,20% of total billed charges,14.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.43,65,,,percent of total billed charges,65% of total billed charges,48.43,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.9,50.66,
BARTONELLA HENSELAE AB.IgM,3300927,CDM,301,RC,86611,HCPCS,outpatient,,,74.5,37.25,,48.43,65,,,percent of total billed charges,65% of total billed charges,50.66,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.9,20,,,percent of total billed charges,20% of total billed charges,14.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.9,20,,,percent of total billed charges,20% of total billed charges,14.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.43,65,,,percent of total billed charges,65% of total billed charges,48.43,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.9,50.66,
BASIC METABOLIC PROF,3300187,CDM,301,RC,80048,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,11.7,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.7,51,
BCT CULT-QUAN ANAEROBIC,3300877,CDM,306,RC,87073,HCPCS,outpatient,,,15,7.5,,9.75,65,,,percent of total billed charges,65% of total billed charges,10.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,10.2,
BE COLORECTAL CA SCRN,3440459,CDM,972,RC,G0122,HCPCS,outpatient,,,100,50,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,110,110,,,fee schedule,110% of Medicare physician fee schedule,110,110,,,fee schedule,110% of Medicare physician fee schedule,,,,,other,Not seperately reimbursable,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,115,115,,,fee schedule,115% of Medicare physician fee schedule,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110,126.5,
BE WITH AIR CONTRAST,3400058,CDM,320,RC,74280,HCPCS,outpatient,,,487,243.5,,316.55,65,,,percent of total billed charges,65% of total billed charges,331.16,68,,,percent of total billed charges,68% of total billed charges,74.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.4,20,,,percent of total billed charges,20% of total billed charges,97.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.4,20,,,percent of total billed charges,20% of total billed charges,97.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,316.55,65,,,percent of total billed charges,65% of total billed charges,316.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,331.16,
BE WITH AIR CONTRAST,3440019,CDM,972,RC,74280,HCPCS,outpatient,,,192.5,96.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,116.83,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.75,110,,,fee schedule,110% of Medicare physician fee schedule,211.75,110,,,fee schedule,110% of Medicare physician fee schedule,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,397.78,115,,,fee schedule,115% of Medicare physician fee schedule,169.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.51,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,116.83,397.78,
BEHAVIORAL QUALITATIVE ANALYSIS OF VOICE,3600097,CDM,440,RC,92524,HCPCS,outpatient,,,169,84.5,,109.85,65,,,percent of total billed charges,65% of total billed charges,114.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.85,65,,,percent of total billed charges,65% of total billed charges,109.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.8,114.92,
BENZOCAINE/MENTHOL LOZ,3500096,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
BENZOIN COMP TINC SWB,3500097,CDM,250,RC,,,outpatient,,,14.05,7.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.81,20,,,percent of total billed charges,20% of total billed charges,2.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.81,20,,,percent of total billed charges,20% of total billed charges,2.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.13,65,,,percent of total billed charges,65% of total billed charges,9.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.81,53.67,
BENZOIN SWAB STICK,3250333,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
BENZONATATE CAP [100 MG],3500098,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
BENZONATATE CAP [200 MG],3500099,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
BENZTROPINE TAB [1 MG],3500100,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
BETA CAR/VIT A/C/E/MIN TA,3500101,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
BETADINE PREP TRAY,6215863,CDM,272,RC,,,outpatient,,,38.75,19.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.75,20,,,percent of total billed charges,20% of total billed charges,7.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.75,20,,,percent of total billed charges,20% of total billed charges,7.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.19,65,,,percent of total billed charges,65% of total billed charges,25.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.75,53.67,
BETADINE SWAB STICK,3250375,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
BETAMETHASONE INJ [6 MG/M,3500102,CDM,636,RC,J0702,HCPCS,outpatient,,,40.4,20.2,,,,,,other,Not reimbursable per contract ,27.47,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.32,80,,,case rate,80% for high cost drug carve out,34.34,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.08,34.34,
BETHANECHOL TAB [10 MG],3500103,CDM,250,RC,,,outpatient,,,10.05,5.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.01,20,,,percent of total billed charges,20% of total billed charges,2.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.01,20,,,percent of total billed charges,20% of total billed charges,2.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.53,65,,,percent of total billed charges,65% of total billed charges,6.53,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.01,53.67,
BILIRUBIN DIRECT,3300033,CDM,301,RC,82248,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,6.94,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.94,54.4,
BILIRUBIN TOTAL,3300035,CDM,301,RC,82247,HCPCS,outpatient,,,26,13,,16.9,65,,,percent of total billed charges,65% of total billed charges,17.68,68,,,percent of total billed charges,68% of total billed charges,6.94,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,20,,,percent of total billed charges,20% of total billed charges,5.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,20,,,percent of total billed charges,20% of total billed charges,5.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.9,65,,,percent of total billed charges,65% of total billed charges,16.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.2,17.68,
BIMATOPROST DRP 0.03%,3500105,CDM,250,RC,,,outpatient,,,308.1,154.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.62,20,,,percent of total billed charges,20% of total billed charges,61.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.62,20,,,percent of total billed charges,20% of total billed charges,61.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,200.27,65,,,percent of total billed charges,65% of total billed charges,200.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,200.27,
BIO-PATCH 3/4 IN PROTECTIVE DISK,3250648,CDM,272,RC,,,outpatient,,,60.6,30.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.12,20,,,percent of total billed charges,20% of total billed charges,12.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.12,20,,,percent of total billed charges,20% of total billed charges,12.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.39,65,,,percent of total billed charges,65% of total billed charges,39.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,53.67,
BIOPSY FORCEP JUMBO,3060179,CDM,272,RC,,,outpatient,,,350,175,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70,20,,,percent of total billed charges,20% of total billed charges,70,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70,20,,,percent of total billed charges,20% of total billed charges,70,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,227.5,65,,,percent of total billed charges,65% of total billed charges,227.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,227.5,
BIOPSY FORCEP LARGE,3060051,CDM,272,RC,,,outpatient,,,139,69.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.35,65,,,percent of total billed charges,65% of total billed charges,90.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.8,90.35,
"BIPOLAR CAUTERY CORD, STERILE",6215870,CDM,272,RC,,,outpatient,,,50.45,25.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.09,20,,,percent of total billed charges,20% of total billed charges,10.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.09,20,,,percent of total billed charges,20% of total billed charges,10.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.79,65,,,percent of total billed charges,65% of total billed charges,32.79,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.09,53.67,
BISACODYL SUPP [10 MG],3500106,CDM,250,RC,,,outpatient,,,5.75,2.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
BISACODYL TAB [5 MG],3500107,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
BISMUTH SUBSAL TAB [262 M,3500110,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
BITE BLOCK C02 CANNU,3220263,CDM,272,RC,,,outpatient,,,79,39.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.8,20,,,percent of total billed charges,20% of total billed charges,15.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.8,20,,,percent of total billed charges,20% of total billed charges,15.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.35,65,,,percent of total billed charges,65% of total billed charges,51.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.8,53.67,
BLADDER IRRI KIT,3250565,CDM,272,RC,,,outpatient,,,34.95,17.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.99,20,,,percent of total billed charges,20% of total billed charges,6.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.99,20,,,percent of total billed charges,20% of total billed charges,6.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.72,65,,,percent of total billed charges,65% of total billed charges,22.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,53.67,
BLD TYPE; RBC AG NOT A/R,3300855,CDM,309,RC,86905,HCPCS,outpatient,,,93,46.5,,60.45,65,,,percent of total billed charges,65% of total billed charges,63.24,68,,,percent of total billed charges,68% of total billed charges,5.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.45,65,,,percent of total billed charges,65% of total billed charges,60.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,63.24,
BLEEDING TIME,3300639,CDM,305,RC,85002,HCPCS,outpatient,,,48,24,,31.2,65,,,percent of total billed charges,65% of total billed charges,32.64,68,,,percent of total billed charges,68% of total billed charges,6.39,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,20,,,percent of total billed charges,20% of total billed charges,9.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,20,,,percent of total billed charges,20% of total billed charges,9.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,65,,,percent of total billed charges,65% of total billed charges,31.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.39,32.64,
BLOOD ADMINISTRATION-IP,3020000,CDM,391,RC,36430,HCPCS,outpatient,,,316,158,,205.4,65,,,percent of total billed charges,65% of total billed charges,214.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.2,20,,,percent of total billed charges,20% of total billed charges,63.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.2,20,,,percent of total billed charges,20% of total billed charges,63.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.4,65,,,percent of total billed charges,65% of total billed charges,205.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,214.88,
BLOOD ADMINISTRATION-OBS,3040000,CDM,391,RC,36430,HCPCS,outpatient,,,316,158,,205.4,65,,,percent of total billed charges,65% of total billed charges,214.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.2,20,,,percent of total billed charges,20% of total billed charges,63.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.2,20,,,percent of total billed charges,20% of total billed charges,63.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.4,65,,,percent of total billed charges,65% of total billed charges,205.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,214.88,
BLOOD ALCOHOL,3300165,CDM,301,RC,82077,HCPCS,outpatient,,,60.5,30.25,,39.33,65,,,percent of total billed charges,65% of total billed charges,41.14,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.1,20,,,percent of total billed charges,20% of total billed charges,12.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.1,20,,,percent of total billed charges,20% of total billed charges,12.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.33,65,,,percent of total billed charges,65% of total billed charges,39.33,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.1,41.14,
BLOOD CULTURE,3300703,CDM,306,RC,87040,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,14.65,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.65,61.2,
"Blood Culture, SO",3300901,CDM,306,RC,87040,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,14.65,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.65,61.2,
BLOOD TRANSFUSION,3230927,CDM,391,RC,36430,HCPCS,outpatient,,,316,158,,205.4,65,,,percent of total billed charges,65% of total billed charges,214.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.2,20,,,percent of total billed charges,20% of total billed charges,63.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.2,20,,,percent of total billed charges,20% of total billed charges,63.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.4,65,,,percent of total billed charges,65% of total billed charges,205.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,214.88,
BODY POS CURRENT STATUS,3600050,CDM,420,RC,G8981,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
BODY POS D/C STATUS,3600052,CDM,420,RC,G8983,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
BODY POS GOAL STATUS,3600051,CDM,420,RC,G8982,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
BONE AGE,3400011,CDM,320,RC,77072,HCPCS,outpatient,,,134,67,,87.1,65,,,percent of total billed charges,65% of total billed charges,91.12,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.8,20,,,percent of total billed charges,20% of total billed charges,26.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.8,20,,,percent of total billed charges,20% of total billed charges,26.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.1,65,,,percent of total billed charges,65% of total billed charges,87.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
BONE AGE,3440021,CDM,972,RC,77072,HCPCS,outpatient,,,52,26,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.13,110,,,fee schedule,110% of Medicare physician fee schedule,28.13,110,,,fee schedule,110% of Medicare physician fee schedule,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.41,115,,,fee schedule,115% of Medicare physician fee schedule,65.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,12.62,65.22,
BOTTLE FEEDING 8 OZ,3250207,CDM,271,RC,,,outpatient,,,7.3,3.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.46,20,,,percent of total billed charges,20% of total billed charges,1.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.46,20,,,percent of total billed charges,20% of total billed charges,1.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.75,65,,,percent of total billed charges,65% of total billed charges,4.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.46,53.67,
BOVIE NEEDLE TIP,6210291,CDM,272,RC,,,outpatient,,,29.7,14.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.94,20,,,percent of total billed charges,20% of total billed charges,5.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.94,20,,,percent of total billed charges,20% of total billed charges,5.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.31,65,,,percent of total billed charges,65% of total billed charges,19.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.94,53.67,
BOVIE PAD(ADULT),6210288,CDM,270,RC,,,outpatient,,,32.2,16.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.44,20,,,percent of total billed charges,20% of total billed charges,6.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.44,20,,,percent of total billed charges,20% of total billed charges,6.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.93,65,,,percent of total billed charges,65% of total billed charges,20.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.44,53.67,
BOVIE PAD(NEONATAL),6215868,CDM,270,RC,,,outpatient,,,161.85,80.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.37,20,,,percent of total billed charges,20% of total billed charges,32.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.37,20,,,percent of total billed charges,20% of total billed charges,32.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.2,65,,,percent of total billed charges,65% of total billed charges,105.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,105.2,
BRIMONIDINE 0.15% DRP,3500114,CDM,250,RC,,,outpatient,,,65.3,32.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.06,20,,,percent of total billed charges,20% of total billed charges,13.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.06,20,,,percent of total billed charges,20% of total billed charges,13.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.45,65,,,percent of total billed charges,65% of total billed charges,42.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.06,53.67,
BUDESONIDE MDI [90 MCG],3500115,CDM,250,RC,,,outpatient,,,596.4,298.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.28,20,,,percent of total billed charges,20% of total billed charges,119.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.28,20,,,percent of total billed charges,20% of total billed charges,119.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,387.66,65,,,percent of total billed charges,65% of total billed charges,387.66,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,357.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,387.66,
BUMETANIDE INJ [0.25 MG/M,3500116,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
BUMETANIDE INJ [1 MG/4 ML,3500117,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
BUMETANIDE TAB [1 MG],3500118,CDM,250,RC,,,outpatient,,,5.5,2.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.1,20,,,percent of total billed charges,20% of total billed charges,1.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.1,20,,,percent of total billed charges,20% of total billed charges,1.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.58,65,,,percent of total billed charges,65% of total billed charges,3.58,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.1,53.67,
BUN,3300037,CDM,301,RC,84520,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,5.6,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
BUPIVACAINE  0.25%,3521936,CDM,636,RC,J3490,HCPCS,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,3.4,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,80,,,case rate,80% for high cost drug carve out,4.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,4.25,
BUPIVACAINE/EPI  0.25-0.0005 %,3521935,CDM,636,RC,J3490,HCPCS,outpatient,,,72.7,36.35,,,,,,other,Not reimbursable per contract ,49.44,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.54,20,,,percent of total billed charges,20% of total billed charges,14.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.54,20,,,percent of total billed charges,20% of total billed charges,14.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.16,80,,,case rate,80% for high cost drug carve out,61.8,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.54,61.8,
BUPROPION SR TAB [100 MG],3500119,CDM,250,RC,,,outpatient,,,8.45,4.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.69,20,,,percent of total billed charges,20% of total billed charges,1.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.69,20,,,percent of total billed charges,20% of total billed charges,1.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.49,65,,,percent of total billed charges,65% of total billed charges,5.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.69,53.67,
BUPROPION SR TAB [150 MG],3500120,CDM,250,RC,,,outpatient,,,9.7,4.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.94,20,,,percent of total billed charges,20% of total billed charges,1.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.94,20,,,percent of total billed charges,20% of total billed charges,1.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.31,65,,,percent of total billed charges,65% of total billed charges,6.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.94,53.67,
BUPROPION TAB [100 MG],3500997,CDM,250,RC,,,outpatient,,,5.3,2.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.06,20,,,percent of total billed charges,20% of total billed charges,1.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.06,20,,,percent of total billed charges,20% of total billed charges,1.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,65,,,percent of total billed charges,65% of total billed charges,3.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.06,53.67,
BUPROPION XL TAB [150 MG],3500995,CDM,250,RC,,,outpatient,,,26.1,13.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.22,20,,,percent of total billed charges,20% of total billed charges,5.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.22,20,,,percent of total billed charges,20% of total billed charges,5.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.97,65,,,percent of total billed charges,65% of total billed charges,16.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.22,53.67,
BUPROPION XL TAB [300 MG],3501014,CDM,250,RC,,,outpatient,,,14,7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.1,65,,,percent of total billed charges,65% of total billed charges,9.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,53.67,
BURN DRES/DEBRID LG,3230909,CDM,450,RC,16030,HCPCS,outpatient,,,228,114,,148.2,65,,,percent of total billed charges,65% of total billed charges,155.04,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.2,65,,,percent of total billed charges,65% of total billed charges,148.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,312,
BURN DRES/DEBRID MED,3230905,CDM,450,RC,16025,HCPCS,outpatient,,,204,102,,132.6,65,,,percent of total billed charges,65% of total billed charges,138.72,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,65,,,percent of total billed charges,65% of total billed charges,132.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,419,
BURN DRES/DEBRID SM,3230901,CDM,450,RC,16020,HCPCS,outpatient,,,139,69.5,,90.35,65,,,percent of total billed charges,65% of total billed charges,94.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.35,65,,,percent of total billed charges,65% of total billed charges,90.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.8,178,
BURN DRESSING,3231035,CDM,450,RC,16000,HCPCS,outpatient,,,103.17,51.59,,67.06,65,,,percent of total billed charges,65% of total billed charges,70.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.63,20,,,percent of total billed charges,20% of total billed charges,20.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.63,20,,,percent of total billed charges,20% of total billed charges,20.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.06,65,,,percent of total billed charges,65% of total billed charges,67.06,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.63,178,
BURN LARGE W/O ANES,3231041,CDM,450,RC,,,outpatient,,,228,114,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.2,65,,,percent of total billed charges,65% of total billed charges,148.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.8,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,148.2,
BURN MEDIUM W/O ANES,3231039,CDM,450,RC,,,outpatient,,,185,92.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,20,,,percent of total billed charges,20% of total billed charges,37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,20,,,percent of total billed charges,20% of total billed charges,37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.25,65,,,percent of total billed charges,65% of total billed charges,120.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.75,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37,120.25,
BURN SMALL W/O ANES,3231037,CDM,450,RC,16020,HCPCS,outpatient,,,139,69.5,,90.35,65,,,percent of total billed charges,65% of total billed charges,94.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.35,65,,,percent of total billed charges,65% of total billed charges,90.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.8,178,
BURN/DEBRID LG,3230911,CDM,450,RC,16030,HCPCS,outpatient,,,228,114,,148.2,65,,,percent of total billed charges,65% of total billed charges,155.04,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.2,65,,,percent of total billed charges,65% of total billed charges,148.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,312,
BUSPIRONE TAB [15 MG],3500123,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
BYSTOLIC TAB [5 MG],3501039,CDM,250,RC,,,outpatient,,,30.1,15.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.02,20,,,percent of total billed charges,20% of total billed charges,6.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.02,20,,,percent of total billed charges,20% of total billed charges,6.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.57,65,,,percent of total billed charges,65% of total billed charges,19.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.02,53.67,
C DIFF AMPLIFIED PROBE,3300879,CDM,306,RC,87493,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,30.6,
C DIFF ANTIGEN,3300226,CDM,300,RC,87449,HCPCS,outpatient,,,72,36,,46.8,65,,,percent of total billed charges,65% of total billed charges,48.96,68,,,percent of total billed charges,68% of total billed charges,16.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,65,,,percent of total billed charges,65% of total billed charges,46.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,48.96,
C DIFF TOXIN,3300228,CDM,300,RC,87324,HCPCS,outpatient,,,72,36,,46.8,65,,,percent of total billed charges,65% of total billed charges,48.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,65,,,percent of total billed charges,65% of total billed charges,46.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,48.96,
C REACTIVE PROTEIN (QUEST),3300483,CDM,302,RC,86140,HCPCS,outpatient,,,55,27.5,,35.75,65,,,percent of total billed charges,65% of total billed charges,37.4,68,,,percent of total billed charges,68% of total billed charges,7.34,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.75,65,,,percent of total billed charges,65% of total billed charges,35.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.34,37.4,
C TRACHOMATIS IGM AB,3300589,CDM,302,RC,86632,HCPCS,outpatient,,,87,43.5,,56.55,65,,,percent of total billed charges,65% of total billed charges,59.16,68,,,percent of total billed charges,68% of total billed charges,18.02,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.4,20,,,percent of total billed charges,20% of total billed charges,17.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.4,20,,,percent of total billed charges,20% of total billed charges,17.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.55,65,,,percent of total billed charges,65% of total billed charges,56.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.4,59.16,
C-ARM DRAPE 36X36,6210265,CDM,272,RC,,,outpatient,,,9.25,4.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.85,20,,,percent of total billed charges,20% of total billed charges,1.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.85,20,,,percent of total billed charges,20% of total billed charges,1.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.01,65,,,percent of total billed charges,65% of total billed charges,6.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.85,53.67,
C-PEPTIDE,3300197,CDM,301,RC,84681,HCPCS,outpatient,,,137,68.5,,89.05,65,,,percent of total billed charges,65% of total billed charges,93.16,68,,,percent of total billed charges,68% of total billed charges,26.52,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.4,20,,,percent of total billed charges,20% of total billed charges,27.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.4,20,,,percent of total billed charges,20% of total billed charges,27.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.05,65,,,percent of total billed charges,65% of total billed charges,89.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.52,93.16,
CA 125,3300495,CDM,302,RC,86304,HCPCS,outpatient,,,118,59,,76.7,65,,,percent of total billed charges,65% of total billed charges,80.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.6,20,,,percent of total billed charges,20% of total billed charges,23.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.6,20,,,percent of total billed charges,20% of total billed charges,23.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.7,65,,,percent of total billed charges,65% of total billed charges,76.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.6,80.24,
CA 15-3,3300523,CDM,302,RC,86300,HCPCS,outpatient,,,160,80,,104,65,,,percent of total billed charges,65% of total billed charges,108.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104,65,,,percent of total billed charges,65% of total billed charges,104,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32,108.8,
CA POLYCARBOPHIL TAB [625,3500126,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
CA-19-9,3300599,CDM,302,RC,86301,HCPCS,outpatient,,,101,50.5,,65.65,65,,,percent of total billed charges,65% of total billed charges,68.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.65,65,,,percent of total billed charges,65% of total billed charges,65.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,68.68,
CAD DIAGNOSTIC,3400137,CDM,401,RC,77051,HCPCS,outpatient,,,120,60,,78,65,,,percent of total billed charges,65% of total billed charges,81.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,65,,,percent of total billed charges,65% of total billed charges,78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,91,
CAD DIAGNOSTIC PRO FEE,3440050,CDM,972,RC,77051,HCPCS,outpatient,,,71.35,35.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,52.6,
CAD SCREENING,3400171,CDM,403,RC,77052,HCPCS,outpatient,,,120,60,,78,65,,,percent of total billed charges,65% of total billed charges,81.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,65,,,percent of total billed charges,65% of total billed charges,78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,91,
CAD SCREENING PRO FEE,3440060,CDM,972,RC,77052,HCPCS,outpatient,,,71.35,35.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,52.6,
CALCITRIOL CAP [0.25 MCG],3500128,CDM,250,RC,,,outpatient,,,6.4,3.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.28,20,,,percent of total billed charges,20% of total billed charges,1.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.28,20,,,percent of total billed charges,20% of total billed charges,1.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.16,65,,,percent of total billed charges,65% of total billed charges,4.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.28,53.67,
CALCIUM,3300039,CDM,301,RC,82310,HCPCS,outpatient,,,30,15,,19.5,65,,,percent of total billed charges,65% of total billed charges,20.4,68,,,percent of total billed charges,68% of total billed charges,7.31,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,20.4,
CALCIUM 24 HR UA,3300205,CDM,301,RC,82340,HCPCS,outpatient,,,52,26,,33.8,65,,,percent of total billed charges,65% of total billed charges,35.36,68,,,percent of total billed charges,68% of total billed charges,8.57,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,35.36,
CALCIUM CARB TAB [500 MG],3500131,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
CALCIUM CARB/ VIT D TAB [,3500132,CDM,250,RC,,,outpatient,,,13.4,6.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.68,20,,,percent of total billed charges,20% of total billed charges,2.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.68,20,,,percent of total billed charges,20% of total billed charges,2.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.71,65,,,percent of total billed charges,65% of total billed charges,8.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.68,53.67,
CALCIUM CARBONATE (TUMS),3500133,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
CALCIUM CL 10% INJ [10 ML,3500134,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CALCIUM CL 10% INJ [10 ML,3500134,CDM,636,RC,J3490,HCPCS,outpatient,,,48.6,24.3,,,,,,other,Not reimbursable per contract ,33.05,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,20,,,percent of total billed charges,20% of total billed charges,9.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,20,,,percent of total billed charges,20% of total billed charges,9.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.88,80,,,case rate,80% for high cost drug carve out,41.31,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,41.31,
CALCIUM GLUC 10 % SDV,3521913,CDM,250,RC,,,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,65,,,percent of total billed charges,65% of total billed charges,10.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.2,53.67,
CALCIUM GLUC 10% INJ [10,3500135,CDM,636,RC,J0610,HCPCS,outpatient,,,49.45,24.73,,,,,,other,Not reimbursable per contract ,33.63,68,,,case rate,68% of high cost drug carve out,1.29,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.89,20,,,percent of total billed charges,20% of total billed charges,9.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.89,20,,,percent of total billed charges,20% of total billed charges,9.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.56,80,,,case rate,80% for high cost drug carve out,42.03,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.29,42.03,
CALCIUM IONIZED,3300357,CDM,301,RC,82330,HCPCS,outpatient,,,67,33.5,,43.55,65,,,percent of total billed charges,65% of total billed charges,45.56,68,,,percent of total billed charges,68% of total billed charges,19.4,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.4,20,,,percent of total billed charges,20% of total billed charges,13.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.4,20,,,percent of total billed charges,20% of total billed charges,13.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.55,65,,,percent of total billed charges,65% of total billed charges,43.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.4,45.56,
CANNULA W/ HEADGEAR LG,4000057,CDM,270,RC,,,outpatient,,,271.65,135.83,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.33,20,,,percent of total billed charges,20% of total billed charges,54.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.33,20,,,percent of total billed charges,20% of total billed charges,54.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,176.57,65,,,percent of total billed charges,65% of total billed charges,176.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,176.57,
CANNULA W/ HEADGEAR MED,4000056,CDM,270,RC,,,outpatient,,,271.65,135.83,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.33,20,,,percent of total billed charges,20% of total billed charges,54.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.33,20,,,percent of total billed charges,20% of total billed charges,54.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,176.57,65,,,percent of total billed charges,65% of total billed charges,176.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,176.57,
"CANNULA, HIGH FLOW NASAL",4000053,CDM,270,RC,,,outpatient,,,66.1,33.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.22,20,,,percent of total billed charges,20% of total billed charges,13.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.22,20,,,percent of total billed charges,20% of total billed charges,13.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.97,65,,,percent of total billed charges,65% of total billed charges,42.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.22,53.67,
CAPTOPRIL TAB [25 MG],3500136,CDM,250,RC,,,outpatient,,,9.25,4.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.85,20,,,percent of total billed charges,20% of total billed charges,1.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.85,20,,,percent of total billed charges,20% of total billed charges,1.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.01,65,,,percent of total billed charges,65% of total billed charges,6.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.85,53.67,
CARBAMAZEPINE,3300155,CDM,301,RC,80156,HCPCS,outpatient,,,74,37,,48.1,65,,,percent of total billed charges,65% of total billed charges,50.32,68,,,percent of total billed charges,68% of total billed charges,20.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.8,20,,,percent of total billed charges,20% of total billed charges,14.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.8,20,,,percent of total billed charges,20% of total billed charges,14.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.1,65,,,percent of total billed charges,65% of total billed charges,48.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.8,50.32,
CARBAMAZEPINE TAB [100 MG,3500137,CDM,250,RC,,,outpatient,,,5.75,2.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
CARBAMAZEPINE TAB [200 MG,3500138,CDM,250,RC,,,outpatient,,,5.6,2.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.12,20,,,percent of total billed charges,20% of total billed charges,1.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.12,20,,,percent of total billed charges,20% of total billed charges,1.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.64,65,,,percent of total billed charges,65% of total billed charges,3.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,53.67,
CARBAMIDE PEROXIDE EAR DROPS 6.5%,3501148,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CARBIDOPA/ LEVO TAB [10-1,3500139,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CARBIDOPA/LEVO TAB [25-10,3500140,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CARBIDOPA/LEVO TAB [25-25,3500141,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CARBON DIOXIDE CO2,3300041,CDM,301,RC,82374,HCPCS,outpatient,,,22,11,,14.3,65,,,percent of total billed charges,65% of total billed charges,14.96,68,,,percent of total billed charges,68% of total billed charges,6.94,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.3,65,,,percent of total billed charges,65% of total billed charges,14.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,14.96,
CARBON MONIXIDE,3300353,CDM,301,RC,82375,HCPCS,outpatient,,,76.75,38.38,,49.89,65,,,percent of total billed charges,65% of total billed charges,52.19,68,,,percent of total billed charges,68% of total billed charges,17.5,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.35,20,,,percent of total billed charges,20% of total billed charges,15.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.35,20,,,percent of total billed charges,20% of total billed charges,15.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.89,65,,,percent of total billed charges,65% of total billed charges,49.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.38,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.35,52.19,
CARBOXYMETHYLCELLULOSE SO,3500142,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
CARDIAC MONITOR,3060043,CDM,271,RC,,,outpatient,,,100,50,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,65,,,percent of total billed charges,65% of total billed charges,65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20,65,
CAROTID DUPLEX SCAN UNIL,3400224,CDM,921,RC,93882,HCPCS,outpatient,,,750,375,,487.5,65,,,percent of total billed charges,65% of total billed charges,510,68,,,percent of total billed charges,68% of total billed charges,87.87,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,20,,,percent of total billed charges,20% of total billed charges,150,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,20,,,percent of total billed charges,20% of total billed charges,150,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,487.5,65,,,percent of total billed charges,65% of total billed charges,487.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,510,
CAROTID DUPLEX SCAN UNIL,3440224,CDM,972,RC,93882,HCPCS,outpatient,,,304.5,152.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,90.47,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.18,110,,,fee schedule,110% of Medicare physician fee schedule,133.18,110,,,fee schedule,110% of Medicare physician fee schedule,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,139.23,115,,,fee schedule,115% of Medicare physician fee schedule,143.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.15,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,90.47,153.15,
CARRAKLENZ WOUND CLEANSER BOTTLE,3250684,CDM,272,RC,,,outpatient,,,61.7,30.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.34,20,,,percent of total billed charges,20% of total billed charges,12.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.34,20,,,percent of total billed charges,20% of total billed charges,12.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.11,65,,,percent of total billed charges,65% of total billed charges,40.11,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.34,53.67,
CARRY CURRENT STATUS,3600053,CDM,420,RC,G8984,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
CARRY D/C STATUS,3600055,CDM,420,RC,G8986,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
CARRY GOAL STATUS,3600054,CDM,420,RC,G8985,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
CARTER-THOMASON CLOSURE,6215838,CDM,272,RC,,,outpatient,,,359.83,179.92,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.97,20,,,percent of total billed charges,20% of total billed charges,71.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.97,20,,,percent of total billed charges,20% of total billed charges,71.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,233.89,65,,,percent of total billed charges,65% of total billed charges,233.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,215.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,233.89,
CARVEDILOL TAB [12.5 MG],3500144,CDM,250,RC,,,outpatient,,,10.55,5.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.11,20,,,percent of total billed charges,20% of total billed charges,2.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.11,20,,,percent of total billed charges,20% of total billed charges,2.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.86,65,,,percent of total billed charges,65% of total billed charges,6.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.11,53.67,
CARVEDILOL TAB [25 MG],3500145,CDM,250,RC,,,outpatient,,,10.55,5.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.11,20,,,percent of total billed charges,20% of total billed charges,2.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.11,20,,,percent of total billed charges,20% of total billed charges,2.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.86,65,,,percent of total billed charges,65% of total billed charges,6.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.11,53.67,
CARVEDILOL TAB [3.125 MG],3500146,CDM,250,RC,,,outpatient,,,10.55,5.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.11,20,,,percent of total billed charges,20% of total billed charges,2.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.11,20,,,percent of total billed charges,20% of total billed charges,2.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.86,65,,,percent of total billed charges,65% of total billed charges,6.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.11,53.67,
CARVEDILOL TAB [6.25 MG],3500147,CDM,250,RC,,,outpatient,,,10.55,5.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.11,20,,,percent of total billed charges,20% of total billed charges,2.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.11,20,,,percent of total billed charges,20% of total billed charges,2.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.86,65,,,percent of total billed charges,65% of total billed charges,6.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.11,53.67,
"CAST PADDING 4""ROLL",3250095,CDM,271,RC,,,outpatient,,,32,16,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.4,20,,,percent of total billed charges,20% of total billed charges,6.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.4,20,,,percent of total billed charges,20% of total billed charges,6.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.8,65,,,percent of total billed charges,65% of total billed charges,20.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.4,53.67,
CATECHOLAMINES FRACTION,3300857,CDM,301,RC,82384,HCPCS,outpatient,,,35,17.5,,22.75,65,,,percent of total billed charges,65% of total billed charges,23.8,68,,,percent of total billed charges,68% of total billed charges,32.92,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.75,65,,,percent of total billed charges,65% of total billed charges,22.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,32.92,
CATECHOLAMINES TOTAL URIN,3300085,CDM,301,RC,82382,HCPCS,outpatient,,,165,82.5,,107.25,65,,,percent of total billed charges,65% of total billed charges,112.2,68,,,percent of total billed charges,68% of total billed charges,24.4,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.25,65,,,percent of total billed charges,65% of total billed charges,107.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.4,112.2,
CATECHOLAMINES; BLOOD,3300885,CDM,301,RC,82383,HCPCS,outpatient,,,26,13,,16.9,65,,,percent of total billed charges,65% of total billed charges,17.68,68,,,percent of total billed charges,68% of total billed charges,35.57,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,20,,,percent of total billed charges,20% of total billed charges,5.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,20,,,percent of total billed charges,20% of total billed charges,5.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.9,65,,,percent of total billed charges,65% of total billed charges,16.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.2,35.57,
CATH BALLOON 30FR,3250537,CDM,272,RC,,,outpatient,,,39.85,19.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.97,20,,,percent of total billed charges,20% of total billed charges,7.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.97,20,,,percent of total billed charges,20% of total billed charges,7.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.9,65,,,percent of total billed charges,65% of total billed charges,25.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.97,53.67,
CATH FOLEY 10FR 3CC,3250603,CDM,272,RC,,,outpatient,,,26.6,13.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.32,20,,,percent of total billed charges,20% of total billed charges,5.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.32,20,,,percent of total billed charges,20% of total billed charges,5.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.29,65,,,percent of total billed charges,65% of total billed charges,17.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,53.67,
CATH FOLEY 10FR/PEDIATRIC,3250596,CDM,272,RC,,,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,53.67,
CATH FOLEY 12 FR/2 WAY,3250598,CDM,272,RC,,,outpatient,,,37.45,18.73,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.49,20,,,percent of total billed charges,20% of total billed charges,7.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.49,20,,,percent of total billed charges,20% of total billed charges,7.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.34,65,,,percent of total billed charges,65% of total billed charges,24.34,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.49,53.67,
"CATH FOLEY 20 FR, 30ML, 3 WAY",3250691,CDM,272,RC,,,outpatient,,,99,49.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,20,,,percent of total billed charges,20% of total billed charges,19.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,20,,,percent of total billed charges,20% of total billed charges,19.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.35,65,,,percent of total billed charges,65% of total billed charges,64.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,64.35,
CATH FOLEY 24FR/30CC,3250489,CDM,272,RC,,,outpatient,,,10.6,5.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.12,20,,,percent of total billed charges,20% of total billed charges,2.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.12,20,,,percent of total billed charges,20% of total billed charges,2.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.89,65,,,percent of total billed charges,65% of total billed charges,6.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,53.67,
CATH FOLEY 8/FR/PEDIATRIC,3250594,CDM,272,RC,,,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,53.67,
CATH FOLEY 8FR 3CC,3250601,CDM,272,RC,,,outpatient,,,26.6,13.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.32,20,,,percent of total billed charges,20% of total billed charges,5.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.32,20,,,percent of total billed charges,20% of total billed charges,5.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.29,65,,,percent of total billed charges,65% of total billed charges,17.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,53.67,
CATH FOLEY STATLOCK ADULT,3250328,CDM,272,RC,,,outpatient,,,25.6,12.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.12,20,,,percent of total billed charges,20% of total billed charges,5.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.12,20,,,percent of total billed charges,20% of total billed charges,5.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.64,65,,,percent of total billed charges,65% of total billed charges,16.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.12,53.67,
CATH FOLEY TRAY 16FR,3250421,CDM,272,RC,,,outpatient,,,72.8,36.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.56,20,,,percent of total billed charges,20% of total billed charges,14.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.56,20,,,percent of total billed charges,20% of total billed charges,14.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.32,65,,,percent of total billed charges,65% of total billed charges,47.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,53.67,
CATH FOLEY TRAY 18FR,3250495,CDM,272,RC,,,outpatient,,,88.7,44.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.74,20,,,percent of total billed charges,20% of total billed charges,17.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.74,20,,,percent of total billed charges,20% of total billed charges,17.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.66,65,,,percent of total billed charges,65% of total billed charges,57.66,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.74,57.66,
CATH FOLEY-COUDE 18FR 10C,3250658,CDM,272,RC,,,outpatient,,,37.82,18.91,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.56,20,,,percent of total billed charges,20% of total billed charges,7.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.56,20,,,percent of total billed charges,20% of total billed charges,7.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.58,65,,,percent of total billed charges,65% of total billed charges,24.58,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,53.67,
CATH FOLEY/COUDE 16FR 5CC,3250656,CDM,272,RC,,,outpatient,,,38.3,19.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.66,20,,,percent of total billed charges,20% of total billed charges,7.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.66,20,,,percent of total billed charges,20% of total billed charges,7.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.9,65,,,percent of total billed charges,65% of total billed charges,24.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.66,53.67,
CATH FOLEYCOUDE 14FR 10CC,3250657,CDM,272,RC,,,outpatient,,,37.82,18.91,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.56,20,,,percent of total billed charges,20% of total billed charges,7.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.56,20,,,percent of total billed charges,20% of total billed charges,7.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.58,65,,,percent of total billed charges,65% of total billed charges,24.58,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.56,53.67,
CATH INSERT COMPLIC,3040025,CDM,270,RC,51703,HCPCS,outpatient,,,142.2,71.1,,92.43,65,,,percent of total billed charges,65% of total billed charges,96.7,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.44,20,,,percent of total billed charges,20% of total billed charges,28.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.44,20,,,percent of total billed charges,20% of total billed charges,28.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.43,65,,,percent of total billed charges,65% of total billed charges,92.43,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.44,178,
CATH INSERT FOLEY,3040024,CDM,270,RC,51702,HCPCS,outpatient,,,118.5,59.25,,77.03,65,,,percent of total billed charges,65% of total billed charges,80.58,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.7,20,,,percent of total billed charges,20% of total billed charges,23.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.7,20,,,percent of total billed charges,20% of total billed charges,23.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.03,65,,,percent of total billed charges,65% of total billed charges,77.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,178,
CATH LEG STRAP,3250101,CDM,271,RC,,,outpatient,,,33.35,16.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.67,20,,,percent of total billed charges,20% of total billed charges,6.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.67,20,,,percent of total billed charges,20% of total billed charges,6.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.68,65,,,percent of total billed charges,65% of total billed charges,21.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.67,53.67,
CATH MALE STRAIGHT 16 FR COUDE,3250097,CDM,272,RC,,,outpatient,,,10.9,5.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.18,20,,,percent of total billed charges,20% of total billed charges,2.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.18,20,,,percent of total billed charges,20% of total billed charges,2.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.09,65,,,percent of total billed charges,65% of total billed charges,7.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.18,53.67,
CATH NEONATAL 5 FR KIT,3250675,CDM,272,RC,,,outpatient,,,16.45,8.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.29,20,,,percent of total billed charges,20% of total billed charges,3.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.29,20,,,percent of total billed charges,20% of total billed charges,3.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.69,65,,,percent of total billed charges,65% of total billed charges,10.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.29,53.67,
CATH PLUG/DRAIN PROT,3250485,CDM,272,RC,,,outpatient,,,5.25,2.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.05,20,,,percent of total billed charges,20% of total billed charges,1.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.05,20,,,percent of total billed charges,20% of total billed charges,1.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.41,65,,,percent of total billed charges,65% of total billed charges,3.41,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.05,53.67,
CATH PORTA 20 G,3250547,CDM,272,RC,,,outpatient,,,53.05,26.53,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.61,20,,,percent of total billed charges,20% of total billed charges,10.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.61,20,,,percent of total billed charges,20% of total billed charges,10.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.48,65,,,percent of total billed charges,65% of total billed charges,34.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.61,53.67,
CATH PORTA 22 G,3250549,CDM,272,RC,,,outpatient,,,53.05,26.53,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.61,20,,,percent of total billed charges,20% of total billed charges,10.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.61,20,,,percent of total billed charges,20% of total billed charges,10.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.48,65,,,percent of total billed charges,65% of total billed charges,34.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.61,53.67,
CATH STRAIGHT (MALE),3250096,CDM,272,RC,,,outpatient,,,2.5,1.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.5,20,,,percent of total billed charges,20% of total billed charges,0.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.5,20,,,percent of total billed charges,20% of total billed charges,0.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.63,65,,,percent of total billed charges,65% of total billed charges,1.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.5,53.67,
CATH STRAIT RES URINE-,3040023,CDM,270,RC,51701,HCPCS,outpatient,,,118.5,59.25,,77.03,65,,,percent of total billed charges,65% of total billed charges,80.58,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.7,20,,,percent of total billed charges,20% of total billed charges,23.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.7,20,,,percent of total billed charges,20% of total billed charges,23.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.03,65,,,percent of total billed charges,65% of total billed charges,77.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,178,
CATH SUCT 8FR KIT,3250487,CDM,272,RC,,,outpatient,,,6.55,3.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.31,20,,,percent of total billed charges,20% of total billed charges,1.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.31,20,,,percent of total billed charges,20% of total billed charges,1.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.26,65,,,percent of total billed charges,65% of total billed charges,4.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.31,53.67,
CATH SUCT KIT 6FR,3250377,CDM,272,RC,,,outpatient,,,5.25,2.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.05,20,,,percent of total billed charges,20% of total billed charges,1.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.05,20,,,percent of total billed charges,20% of total billed charges,1.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.41,65,,,percent of total billed charges,65% of total billed charges,3.41,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.05,53.67,
CATH TEXAS,3250483,CDM,272,RC,,,outpatient,,,3.85,1.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.77,20,,,percent of total billed charges,20% of total billed charges,0.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.77,20,,,percent of total billed charges,20% of total billed charges,0.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,65,,,percent of total billed charges,65% of total billed charges,2.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.77,53.67,
"CATH TRAY, 15 FR SURGICAL",6210263,CDM,272,RC,,,outpatient,,,24.45,12.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.89,20,,,percent of total billed charges,20% of total billed charges,4.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.89,20,,,percent of total billed charges,20% of total billed charges,4.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.89,65,,,percent of total billed charges,65% of total billed charges,15.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,53.67,
"CATH, RUBBER 8 FRX16",6215903,CDM,272,RC,,,outpatient,,,5.75,2.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
CATH-COUDE RED 14FR,3250676,CDM,272,RC,,,outpatient,,,33.8,16.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.76,20,,,percent of total billed charges,20% of total billed charges,6.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.76,20,,,percent of total billed charges,20% of total billed charges,6.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.97,65,,,percent of total billed charges,65% of total billed charges,21.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.76,53.67,
CATHETER DBL LUME 18/20 G,3250661,CDM,272,RC,,,outpatient,,,62.5,31.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,20,,,percent of total billed charges,20% of total billed charges,12.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,20,,,percent of total billed charges,20% of total billed charges,12.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.63,65,,,percent of total billed charges,65% of total billed charges,40.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.5,53.67,
CATHETER DBL LUME 20/22 G,3250662,CDM,272,RC,,,outpatient,,,62.5,31.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,20,,,percent of total billed charges,20% of total billed charges,12.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,20,,,percent of total billed charges,20% of total billed charges,12.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.63,65,,,percent of total billed charges,65% of total billed charges,40.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.5,53.67,
CATHETER KIT ADULT,3250621,CDM,272,RC,,,outpatient,,,20.7,10.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.14,20,,,percent of total billed charges,20% of total billed charges,4.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.14,20,,,percent of total billed charges,20% of total billed charges,4.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.46,65,,,percent of total billed charges,65% of total billed charges,13.46,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.14,53.67,
CATHILON 14G 2 1/2IN,3250433,CDM,272,RC,,,outpatient,,,16.65,8.33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.33,20,,,percent of total billed charges,20% of total billed charges,3.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.33,20,,,percent of total billed charges,20% of total billed charges,3.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.82,65,,,percent of total billed charges,65% of total billed charges,10.82,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,53.67,
CATHILON 16G,6215861,CDM,272,RC,,,outpatient,,,13.7,6.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.74,20,,,percent of total billed charges,20% of total billed charges,2.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.74,20,,,percent of total billed charges,20% of total billed charges,2.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.91,65,,,percent of total billed charges,65% of total billed charges,8.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.74,53.67,
CATHILON 18G 1 3/4IN,3250441,CDM,272,RC,,,outpatient,,,16.75,8.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,20,,,percent of total billed charges,20% of total billed charges,3.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,20,,,percent of total billed charges,20% of total billed charges,3.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.89,65,,,percent of total billed charges,65% of total billed charges,10.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.35,53.67,
CATHILON 20G 1 1/4IN,3250437,CDM,272,RC,,,outpatient,,,16.75,8.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,20,,,percent of total billed charges,20% of total billed charges,3.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,20,,,percent of total billed charges,20% of total billed charges,3.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.89,65,,,percent of total billed charges,65% of total billed charges,10.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.35,53.67,
CATHILON 22G 1 IN,3250439,CDM,272,RC,,,outpatient,,,16.75,8.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,20,,,percent of total billed charges,20% of total billed charges,3.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,20,,,percent of total billed charges,20% of total billed charges,3.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.89,65,,,percent of total billed charges,65% of total billed charges,10.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.35,53.67,
CATHILON 22G X 1.88,3250092,CDM,272,RC,,,outpatient,,,18.16,9.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.63,20,,,percent of total billed charges,20% of total billed charges,3.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.63,20,,,percent of total billed charges,20% of total billed charges,3.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,65,,,percent of total billed charges,65% of total billed charges,11.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,53.67,
CATHILON 24G 3/4 IN,3250447,CDM,272,RC,,,outpatient,,,16.75,8.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,20,,,percent of total billed charges,20% of total billed charges,3.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,20,,,percent of total billed charges,20% of total billed charges,3.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.89,65,,,percent of total billed charges,65% of total billed charges,10.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.35,53.67,
CAUTERY 1/2 FINE TIP,3250450,CDM,272,RC,,,outpatient,,,99.11,49.56,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.82,20,,,percent of total billed charges,20% of total billed charges,19.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.82,20,,,percent of total billed charges,20% of total billed charges,19.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.42,65,,,percent of total billed charges,65% of total billed charges,64.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.82,64.42,
CAUTERY GROUNDING PA,3060057,CDM,272,RC,,,outpatient,,,45,22.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,53.67,
CAUTERY PENCIL 15',6210286,CDM,272,RC,,,outpatient,,,228.6,114.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.72,20,,,percent of total billed charges,20% of total billed charges,45.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.72,20,,,percent of total billed charges,20% of total billed charges,45.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.59,65,,,percent of total billed charges,65% of total billed charges,148.59,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,137.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.72,148.59,
CBC,3300661,CDM,305,RC,85027,HCPCS,outpatient,,,27.5,13.75,,17.88,65,,,percent of total billed charges,65% of total billed charges,18.7,68,,,percent of total billed charges,68% of total billed charges,9.19,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.5,20,,,percent of total billed charges,20% of total billed charges,5.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.5,20,,,percent of total billed charges,20% of total billed charges,5.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.88,65,,,percent of total billed charges,65% of total billed charges,17.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.5,18.7,
CBC WITH DIFF,3300641,CDM,305,RC,85025,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,11.04,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,30.6,
CD4 & CD8,3300611,CDM,302,RC,86360,HCPCS,outpatient,,,169,84.5,,109.85,65,,,percent of total billed charges,65% of total billed charges,114.92,68,,,percent of total billed charges,68% of total billed charges,9.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.85,65,,,percent of total billed charges,65% of total billed charges,109.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,114.92,
CD4/CD8 INC RATIO,3300623,CDM,302,RC,86360,HCPCS,outpatient,,,220,110,,143,65,,,percent of total billed charges,65% of total billed charges,149.6,68,,,percent of total billed charges,68% of total billed charges,9.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,149.6,
CEA,3300129,CDM,301,RC,82378,HCPCS,outpatient,,,85,42.5,,55.25,65,,,percent of total billed charges,65% of total billed charges,57.8,68,,,percent of total billed charges,68% of total billed charges,26.93,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.25,65,,,percent of total billed charges,65% of total billed charges,55.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17,57.8,
CEFAZOLIN INJ [1GM],3500150,CDM,636,RC,J0690,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CEFDINIR CAP [300 MG],3500152,CDM,250,RC,,,outpatient,,,25.55,12.78,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.11,20,,,percent of total billed charges,20% of total billed charges,5.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.11,20,,,percent of total billed charges,20% of total billed charges,5.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.61,65,,,percent of total billed charges,65% of total billed charges,16.61,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.11,53.67,
CEFDINIR SUSP [125 MG/5 M,3500153,CDM,250,RC,,,outpatient,,,21.25,10.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.25,20,,,percent of total billed charges,20% of total billed charges,4.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.25,20,,,percent of total billed charges,20% of total billed charges,4.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.81,65,,,percent of total billed charges,65% of total billed charges,13.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.25,53.67,
CEFEPIME INJ [1 GM],3500154,CDM,636,RC,J0692,HCPCS,outpatient,,,30.8,15.4,,,,,,other,Not reimbursable per contract ,20.94,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.16,20,,,percent of total billed charges,20% of total billed charges,6.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.16,20,,,percent of total billed charges,20% of total billed charges,6.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.64,80,,,case rate,80% for high cost drug carve out,26.18,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.16,26.18,
CEFTRIAXONE INJ [1 GM],3500156,CDM,636,RC,J0696,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CEFTRIAXONE INJ [2 GM],3500157,CDM,636,RC,J0696,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CEFTRIAXONE INJ [250 MG],3500158,CDM,636,RC,J0696,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CEFTRIAXONE INJ [500 MG],3500159,CDM,636,RC,J0696,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CELECOXIB CAP [100 MG],3500160,CDM,250,RC,,,outpatient,,,48.6,24.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,20,,,percent of total billed charges,20% of total billed charges,9.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,20,,,percent of total billed charges,20% of total billed charges,9.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.59,65,,,percent of total billed charges,65% of total billed charges,31.59,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,53.67,
CELECOXIB CAP [200 MG],3500161,CDM,250,RC,,,outpatient,,,37.9,18.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.58,20,,,percent of total billed charges,20% of total billed charges,7.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.58,20,,,percent of total billed charges,20% of total billed charges,7.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.64,65,,,percent of total billed charges,65% of total billed charges,24.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.58,53.67,
CELL COUNT BODY FLD,3300801,CDM,309,RC,89051,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,7.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.82,27.2,
CENT LNE DRES TRAY CSE-20,3250637,CDM,272,RC,,,outpatient,,,26.75,13.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.35,20,,,percent of total billed charges,20% of total billed charges,5.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.35,20,,,percent of total billed charges,20% of total billed charges,5.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.39,65,,,percent of total billed charges,65% of total billed charges,17.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.35,53.67,
CENTRAL LINE INFUSIO,3020031,CDM,360,RC,,,outpatient,,,280,140,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,65,,,percent of total billed charges,65% of total billed charges,182,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,182,
CENTRAL LINE PLACEMENT KIT,3250448,CDM,272,RC,,,outpatient,,,187.55,93.78,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.51,20,,,percent of total billed charges,20% of total billed charges,37.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.51,20,,,percent of total billed charges,20% of total billed charges,37.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.91,65,,,percent of total billed charges,65% of total billed charges,121.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.51,121.91,
CEPHALEXIN CAP [250 MG],3500164,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CEPHALEXIN CAP [500 MG],3500165,CDM,250,RC,,,outpatient,,,6.8,3.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.36,20,,,percent of total billed charges,20% of total billed charges,1.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.36,20,,,percent of total billed charges,20% of total billed charges,1.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.42,65,,,percent of total billed charges,65% of total billed charges,4.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.36,53.67,
CEPHALEXIN SUSP [250 MG/5,3500166,CDM,250,RC,,,outpatient,,,7.2,3.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,20,,,percent of total billed charges,20% of total billed charges,1.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,20,,,percent of total billed charges,20% of total billed charges,1.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.68,65,,,percent of total billed charges,65% of total billed charges,4.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,53.67,
CERULOPLASM,3300213,CDM,301,RC,82390,HCPCS,outpatient,,,69,34.5,,44.85,65,,,percent of total billed charges,65% of total billed charges,46.92,68,,,percent of total billed charges,68% of total billed charges,15.25,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,20,,,percent of total billed charges,20% of total billed charges,13.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,20,,,percent of total billed charges,20% of total billed charges,13.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.85,65,,,percent of total billed charges,65% of total billed charges,44.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,46.92,
CERV SPINE 2/3 VIEW,3400044,CDM,320,RC,72040,HCPCS,outpatient,,,325,162.5,,211.25,65,,,percent of total billed charges,65% of total billed charges,221,68,,,percent of total billed charges,68% of total billed charges,20.13,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,20,,,percent of total billed charges,20% of total billed charges,65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,20,,,percent of total billed charges,20% of total billed charges,65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,211.25,65,,,percent of total billed charges,65% of total billed charges,211.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.13,221,
CERV SPINE 2OR3 VIEW,3440025,CDM,972,RC,72040,HCPCS,outpatient,,,58.3,29.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.05,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.56,110,,,fee schedule,110% of Medicare physician fee schedule,42.56,110,,,fee schedule,110% of Medicare physician fee schedule,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,220.89,115,,,fee schedule,115% of Medicare physician fee schedule,70.65,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.05,220.89,
CERV SPINE COMPLETE,3400043,CDM,320,RC,72052,HCPCS,outpatient,,,375,187.5,,243.75,65,,,percent of total billed charges,65% of total billed charges,255,68,,,percent of total billed charges,68% of total billed charges,37.86,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,20,,,percent of total billed charges,20% of total billed charges,75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,20,,,percent of total billed charges,20% of total billed charges,75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,243.75,65,,,percent of total billed charges,65% of total billed charges,243.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.86,255,
CERV SPINE COMPLETE,3440023,CDM,972,RC,72052,HCPCS,outpatient,,,74.8,37.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.66,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.76,110,,,fee schedule,110% of Medicare physician fee schedule,66.76,110,,,fee schedule,110% of Medicare physician fee schedule,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,246.19,115,,,fee schedule,115% of Medicare physician fee schedule,83.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.66,246.19,
CERVICAL COLLAR COMFO-EZE,3250677,CDM,271,RC,,,outpatient,,,89.55,44.78,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.91,20,,,percent of total billed charges,20% of total billed charges,17.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.91,20,,,percent of total billed charges,20% of total billed charges,17.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.21,65,,,percent of total billed charges,65% of total billed charges,58.21,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,58.21,
CERVICAL COLLAR LG,3250113,CDM,274,RC,L0120,HCPCS,both,,,40.9,20.45,,26.59,65,,,percent of total billed charges,65% of total billed charges,27.81,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.18,20,,,percent of total billed charges,20% of total billed charges,8.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.18,20,,,percent of total billed charges,20% of total billed charges,8.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.72,80,,,case rate,80% for implant carve out,34.77,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.18,34.77,
CERVICAL COLLAR SM,3250169,CDM,274,RC,L0120,HCPCS,both,,,24.8,12.4,,16.12,65,,,percent of total billed charges,65% of total billed charges,16.86,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.96,20,,,percent of total billed charges,20% of total billed charges,4.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.96,20,,,percent of total billed charges,20% of total billed charges,4.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.84,80,,,case rate,80% for implant carve out,21.08,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.96,21.08,
CERVICAL COLLAR- PEDIATRIC,3250670,CDM,274,RC,,,both,,,59.34,29.67,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.87,20,,,percent of total billed charges,20% of total billed charges,11.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.87,20,,,percent of total billed charges,20% of total billed charges,11.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.47,80,,,case rate,80% for implant carve out,50.44,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.87,50.44,
CERVICAL COLLAR-ADULT,3250669,CDM,274,RC,L0174,HCPCS,both,,,59.4,29.7,,38.61,65,,,percent of total billed charges,65% of total billed charges,40.39,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.88,20,,,percent of total billed charges,20% of total billed charges,11.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.88,20,,,percent of total billed charges,20% of total billed charges,11.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.52,80,,,case rate,80% for implant carve out,50.49,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.88,50.49,
CERVICAL COLLAR-INFANT,3250679,CDM,271,RC,,,outpatient,,,36.3,18.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.26,20,,,percent of total billed charges,20% of total billed charges,7.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.26,20,,,percent of total billed charges,20% of total billed charges,7.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.6,65,,,percent of total billed charges,65% of total billed charges,23.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,53.67,
CETIRIZINE TAB [10 MG],3500168,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CHARCOAL AQUEOUS [25 GM],3500169,CDM,250,RC,J3490,HCPCS,outpatient,,,148.45,74.23,,96.49,65,,,percent of total billed charges,65% of total billed charges,100.95,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.69,20,,,percent of total billed charges,20% of total billed charges,29.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.69,20,,,percent of total billed charges,20% of total billed charges,29.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.49,65,,,percent of total billed charges,65% of total billed charges,96.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.69,100.95,
CHARCOAL/SORBITOL SUSP [5,3500170,CDM,250,RC,,,outpatient,,,118.25,59.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.65,20,,,percent of total billed charges,20% of total billed charges,23.65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.65,20,,,percent of total billed charges,20% of total billed charges,23.65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.86,65,,,percent of total billed charges,65% of total billed charges,76.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.65,76.86,
CHARITY INSULIN,350800,CDM,636,RC,,,outpatient,,,95.35,47.68,,,,,,other,Not reimbursable per contract ,64.84,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.07,20,,,percent of total billed charges,20% of total billed charges,19.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.07,20,,,percent of total billed charges,20% of total billed charges,19.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.28,80,,,case rate,80% for high cost drug carve out,81.05,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.07,81.05,
CHEMICAL CAUTERIZATION GRAN TISSUE,3060412,CDM,360,RC,17250,HCPCS,outpatient,,,950,475,,617.5,65,,,percent of total billed charges,65% of total billed charges,646,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,20,,,percent of total billed charges,20% of total billed charges,190,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,20,,,percent of total billed charges,20% of total billed charges,190,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,617.5,65,,,percent of total billed charges,65% of total billed charges,617.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,646,
CHEMICAL CAUTERIZATION GRAN TISSUE,3462003,CDM,982,RC,17250,HCPCS,outpatient,,,410,205,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.53,110,,,fee schedule,110% of Medicare physician fee schedule,41.53,110,,,fee schedule,110% of Medicare physician fee schedule,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.41,115,,,fee schedule,115% of Medicare physician fee schedule,77.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,24.72,77.32,
CHEMICAL CAUTERIZATION GRAN TISSUE PF,3700272,CDM,983,RC,17250,HCPCS,outpatient,,,137,68.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.53,110,,,fee schedule,110% of Medicare physician fee schedule,41.53,110,,,fee schedule,110% of Medicare physician fee schedule,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.41,115,,,fee schedule,115% of Medicare physician fee schedule,77.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,24.72,77.32,
CHEMICAL CAUTERY TISSUE,3700285,CDM,510,RC,17250,HCPCS,outpatient,,,300,150,,195,65,,,percent of total billed charges,65% of total billed charges,204,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,65,,,percent of total billed charges,65% of total billed charges,195,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,204,
CHEST DRAIN UNIT,3250417,CDM,272,RC,,,outpatient,,,338.05,169.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.61,20,,,percent of total billed charges,20% of total billed charges,67.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.61,20,,,percent of total billed charges,20% of total billed charges,67.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,219.73,65,,,percent of total billed charges,65% of total billed charges,219.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,219.73,
CHEST PA & LATERAL,3400125,CDM,324,RC,71046,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,20.37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,180,
CHEST PA & LATERAL,3440027,CDM,972,RC,71046,HCPCS,outpatient,,,52,26,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.85,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.26,110,,,fee schedule,110% of Medicare physician fee schedule,36.26,110,,,fee schedule,110% of Medicare physician fee schedule,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.3,115,,,fee schedule,115% of Medicare physician fee schedule,69.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.85,214.3,
CHEST PA HEALTH DEPT,3400127,CDM,324,RC,71010,HCPCS,outpatient,,,55.02,27.51,,35.76,65,,,percent of total billed charges,65% of total billed charges,37.41,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.76,65,,,percent of total billed charges,65% of total billed charges,35.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11,180,
CHEST PA ONLY,3400124,CDM,324,RC,71045,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,15.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,180,
CHEST PA ONLY,3440029,CDM,972,RC,71045,HCPCS,outpatient,,,42,21,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.06,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.11,110,,,fee schedule,110% of Medicare physician fee schedule,28.11,110,,,fee schedule,110% of Medicare physician fee schedule,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,205.78,115,,,fee schedule,115% of Medicare physician fee schedule,63.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.06,205.78,
CHEST PLACEMENT ONLY,3400190,CDM,400,RC,43752,HCPCS,outpatient,,,173.73,86.87,,112.92,65,,,percent of total billed charges,65% of total billed charges,118.14,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.75,20,,,percent of total billed charges,20% of total billed charges,34.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.75,20,,,percent of total billed charges,20% of total billed charges,34.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.92,65,,,percent of total billed charges,65% of total billed charges,112.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.75,178,
CHEST PLACEMENT ONLY,3440447,CDM,972,RC,43752,HCPCS,outpatient,,,42.74,21.37,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,28.32,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.41,110,,,fee schedule,110% of Medicare physician fee schedule,45.41,110,,,fee schedule,110% of Medicare physician fee schedule,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.47,115,,,fee schedule,115% of Medicare physician fee schedule,80.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.32,80.92,
CHEST PORTABLE AP,3400051,CDM,320,RC,71045,HCPCS,outpatient,,,225,112.5,,146.25,65,,,percent of total billed charges,65% of total billed charges,153,68,,,percent of total billed charges,68% of total billed charges,15.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,20,,,percent of total billed charges,20% of total billed charges,45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,20,,,percent of total billed charges,20% of total billed charges,45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.25,65,,,percent of total billed charges,65% of total billed charges,146.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,180,
CHLAMYDIA AB IGG,3300627,CDM,302,RC,86631,HCPCS,outpatient,,,41.7,20.85,,27.11,65,,,percent of total billed charges,65% of total billed charges,28.36,68,,,percent of total billed charges,68% of total billed charges,16.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.34,20,,,percent of total billed charges,20% of total billed charges,8.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.34,20,,,percent of total billed charges,20% of total billed charges,8.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.11,65,,,percent of total billed charges,65% of total billed charges,27.11,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.85,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,28.36,
CHLAMYDIA CULTURE,3300713,CDM,306,RC,87110,HCPCS,outpatient,,,147.4,73.7,,95.81,65,,,percent of total billed charges,65% of total billed charges,100.23,68,,,percent of total billed charges,68% of total billed charges,23.47,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.48,20,,,percent of total billed charges,20% of total billed charges,29.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.48,20,,,percent of total billed charges,20% of total billed charges,29.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.81,65,,,percent of total billed charges,65% of total billed charges,95.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.7,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.47,100.23,
CHLAMYDIA PCR SWB/UR,3300761,CDM,306,RC,87491,HCPCS,outpatient,,,129,64.5,,83.85,65,,,percent of total billed charges,65% of total billed charges,87.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.85,65,,,percent of total billed charges,65% of total billed charges,83.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,87.72,
CHLAMYDIA/GC G PROBE,3300721,CDM,306,RC,87797,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,17.6,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,51,
CHLOHEXIDINE GLURONETE 0.12%,3501265,CDM,250,RC,,,outpatient,,,5.75,2.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
CHLORDIAZEPOXIDE CAP [25,3500172,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
CHLORDIAZEPOXIDE CAP [5 M,3500967,CDM,250,RC,,,outpatient,,,7.75,3.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
CHLORHEX/ ISOPRP ALC LIQ,3500173,CDM,250,RC,J3490,HCPCS,outpatient,,,34.9,17.45,,22.69,65,,,percent of total billed charges,65% of total billed charges,23.73,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.98,20,,,percent of total billed charges,20% of total billed charges,6.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.98,20,,,percent of total billed charges,20% of total billed charges,6.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.69,65,,,percent of total billed charges,65% of total billed charges,22.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.98,53.67,
CHLORIDE,3300043,CDM,301,RC,82435,HCPCS,outpatient,,,21,10.5,,13.65,65,,,percent of total billed charges,65% of total billed charges,14.28,68,,,percent of total billed charges,68% of total billed charges,6.52,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.65,65,,,percent of total billed charges,65% of total billed charges,13.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,14.28,
CHLORPROMAZINE INJ [25 MG,3500174,CDM,636,RC,J3230,HCPCS,outpatient,,,89.4,44.7,,,,,,other,Not reimbursable per contract ,60.79,68,,,case rate,68% of high cost drug carve out,1.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.88,20,,,percent of total billed charges,20% of total billed charges,17.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.88,20,,,percent of total billed charges,20% of total billed charges,17.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.52,80,,,case rate,80% for high cost drug carve out,75.99,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.66,75.99,
CHLORTHALIDONE TAB [25 MG,3501021,CDM,250,RC,,,outpatient,,,6.05,3.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.21,20,,,percent of total billed charges,20% of total billed charges,1.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.21,20,,,percent of total billed charges,20% of total billed charges,1.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.93,65,,,percent of total billed charges,65% of total billed charges,3.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.21,53.67,
CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL S,3462073,CDM,982,RC,47480,HCPCS,outpatient,,,1246,623,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,579.83,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,1010.12,110,,,fee schedule,110% of Medicare physician fee schedule,1010.12,110,,,fee schedule,110% of Medicare physician fee schedule,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,1056.03,115,,,fee schedule,115% of Medicare physician fee schedule,632.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,579.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1161.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,579.83,1161.64,
CHOLECYSTECTOMY OPEN W/IOC,3462031,CDM,982,RC,47605,HCPCS,outpatient,,,1608,804,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,808.74,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,1309.68,110,,,fee schedule,110% of Medicare physician fee schedule,1309.68,110,,,fee schedule,110% of Medicare physician fee schedule,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,1369.21,115,,,fee schedule,115% of Medicare physician fee schedule,861.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,808.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1506.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,808.74,1506.13,
CHOLESTEROL,3300087,CDM,301,RC,82465,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,4.69,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.69,17,
CHOLESTEROL HDL,3300027,CDM,301,RC,83718,HCPCS,outpatient,,,38.5,19.25,,25.03,65,,,percent of total billed charges,65% of total billed charges,26.18,68,,,percent of total billed charges,68% of total billed charges,11.62,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.7,20,,,percent of total billed charges,20% of total billed charges,7.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.7,20,,,percent of total billed charges,20% of total billed charges,7.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.03,65,,,percent of total billed charges,65% of total billed charges,25.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,26.18,
CHOLESTYRAMINE PKT [4 GM],3500177,CDM,250,RC,,,outpatient,,,16.85,8.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.37,20,,,percent of total billed charges,20% of total billed charges,3.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.37,20,,,percent of total billed charges,20% of total billed charges,3.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.95,65,,,percent of total billed charges,65% of total billed charges,10.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.37,53.67,
CILOSTAZOL TAB [100 MG],3500178,CDM,250,RC,,,outpatient,,,11.25,5.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.25,20,,,percent of total billed charges,20% of total billed charges,2.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.25,20,,,percent of total billed charges,20% of total billed charges,2.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.31,65,,,percent of total billed charges,65% of total billed charges,7.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,53.67,
CIPROFLOXACIN 400MG (2MG/ML) INJ 5%DEX,3500179,CDM,636,RC,J0744,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CIPROFLOXACIN TAB [250 MG,3500180,CDM,250,RC,,,outpatient,,,27.3,13.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.46,20,,,percent of total billed charges,20% of total billed charges,5.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.46,20,,,percent of total billed charges,20% of total billed charges,5.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.75,65,,,percent of total billed charges,65% of total billed charges,17.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,53.67,
CIPROFLOXACIN TAB [500 MG,3500181,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CIRCUIT VENTILATOR,3170017,CDM,271,RC,,,outpatient,,,120,60,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,65,,,percent of total billed charges,65% of total billed charges,78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,78,
"CIRCUIT, HEATED BIPAP",4000058,CDM,270,RC,,,outpatient,,,342.7,171.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.54,20,,,percent of total billed charges,20% of total billed charges,68.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.54,20,,,percent of total billed charges,20% of total billed charges,68.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,222.76,65,,,percent of total billed charges,65% of total billed charges,222.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,222.76,
CIRCUM 28 DAYS OR OLDER,3462117,CDM,982,RC,54161,HCPCS,outpatient,,,650,325,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.67,110,,,fee schedule,110% of Medicare physician fee schedule,219.67,110,,,fee schedule,110% of Medicare physician fee schedule,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.66,115,,,fee schedule,115% of Medicare physician fee schedule,191.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.62,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,138.71,252.62,
CITALOPRAM TAB [20 MG],3500182,CDM,250,RC,,,outpatient,,,13.5,6.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.7,20,,,percent of total billed charges,20% of total billed charges,2.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.7,20,,,percent of total billed charges,20% of total billed charges,2.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.78,65,,,percent of total billed charges,65% of total billed charges,8.78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.7,53.67,
CITALOPRAM TAB [40 MG],3500183,CDM,250,RC,J3490,HCPCS,outpatient,,,17.5,8.75,,11.38,65,,,percent of total billed charges,65% of total billed charges,11.9,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.5,20,,,percent of total billed charges,20% of total billed charges,3.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.5,20,,,percent of total billed charges,20% of total billed charges,3.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.38,65,,,percent of total billed charges,65% of total billed charges,11.38,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.5,53.67,
CITRATE 24 HOUR UA,3300211,CDM,301,RC,82507,HCPCS,outpatient,,,203,101.5,,131.95,65,,,percent of total billed charges,65% of total billed charges,138.04,68,,,percent of total billed charges,68% of total billed charges,39.47,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.6,20,,,percent of total billed charges,20% of total billed charges,40.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.6,20,,,percent of total billed charges,20% of total billed charges,40.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,131.95,65,,,percent of total billed charges,65% of total billed charges,131.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,121.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.47,138.04,
CK MB,3300025,CDM,301,RC,82553,HCPCS,outpatient,,,60.5,30.25,,39.33,65,,,percent of total billed charges,65% of total billed charges,41.14,68,,,percent of total billed charges,68% of total billed charges,12.86,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.1,20,,,percent of total billed charges,20% of total billed charges,12.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.1,20,,,percent of total billed charges,20% of total billed charges,12.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.33,65,,,percent of total billed charges,65% of total billed charges,39.33,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.1,41.14,
CK TOTAL,3300045,CDM,301,RC,82550,HCPCS,outpatient,,,22,11,,14.3,65,,,percent of total billed charges,65% of total billed charges,14.96,68,,,percent of total billed charges,68% of total billed charges,9.25,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.3,65,,,percent of total billed charges,65% of total billed charges,14.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,14.96,
CK W/O MMB,3300883,CDM,301,RC,82550,HCPCS,outpatient,,,22,11,,14.3,65,,,percent of total billed charges,65% of total billed charges,14.96,68,,,percent of total billed charges,68% of total billed charges,9.25,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.3,65,,,percent of total billed charges,65% of total billed charges,14.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,14.96,
CLARITHROMYCIN TAB [500 M,3500185,CDM,250,RC,,,outpatient,,,30.1,15.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.02,20,,,percent of total billed charges,20% of total billed charges,6.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.02,20,,,percent of total billed charges,20% of total billed charges,6.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.57,65,,,percent of total billed charges,65% of total billed charges,19.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.02,53.67,
CLAVICLE BIL,3440037,CDM,972,RC,73000,HCPCS,outpatient,,,70,35,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.69,115,,,fee schedule,115% of Medicare physician fee schedule,67.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.14,212.69,
CLAVICLE LT,3440039,CDM,972,RC,73000,HCPCS,outpatient,,,45.1,22.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.69,115,,,fee schedule,115% of Medicare physician fee schedule,67.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.14,212.69,
CLAVICLE RT,3440041,CDM,972,RC,73000,HCPCS,outpatient,,,45.1,22.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.69,115,,,fee schedule,115% of Medicare physician fee schedule,67.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.14,212.69,
CLAVICLE-BIL,3400068,CDM,320,RC,73000,HCPCS,outpatient,,,212,106,,137.8,65,,,percent of total billed charges,65% of total billed charges,144.16,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.8,65,,,percent of total billed charges,65% of total billed charges,137.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
CLAVICLE-L,3400015,CDM,320,RC,73000,HCPCS,outpatient,,,151,75.5,,98.15,65,,,percent of total billed charges,65% of total billed charges,102.68,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.2,20,,,percent of total billed charges,20% of total billed charges,30.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.2,20,,,percent of total billed charges,20% of total billed charges,30.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98.15,65,,,percent of total billed charges,65% of total billed charges,98.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
CLAVICLE-R,3400067,CDM,320,RC,73000,HCPCS,outpatient,,,151,75.5,,98.15,65,,,percent of total billed charges,65% of total billed charges,102.68,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.2,20,,,percent of total billed charges,20% of total billed charges,30.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.2,20,,,percent of total billed charges,20% of total billed charges,30.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98.15,65,,,percent of total billed charges,65% of total billed charges,98.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
CLINDAMYCIN CAP [150 MG],3500188,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CLINDAMYCIN INJ [600 MG/4,3500190,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CLINDAMYCIN INJ [900 MG/6,3500191,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
CLINDAMYCIN/D5W PREMIX  [,3500958,CDM,250,RC,J3490,HCPCS,outpatient,,,94.2,47.1,,61.23,65,,,percent of total billed charges,65% of total billed charges,64.06,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.84,20,,,percent of total billed charges,20% of total billed charges,18.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.84,20,,,percent of total billed charges,20% of total billed charges,18.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.23,65,,,percent of total billed charges,65% of total billed charges,61.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.84,64.06,
CLOBETASOL 0.05% CRM,3500193,CDM,250,RC,J3490,HCPCS,outpatient,,,136.3,68.15,,88.6,65,,,percent of total billed charges,65% of total billed charges,92.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.26,20,,,percent of total billed charges,20% of total billed charges,27.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.26,20,,,percent of total billed charges,20% of total billed charges,27.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.6,65,,,percent of total billed charges,65% of total billed charges,88.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.26,92.68,
CLONAZEPAM TAB [0.5 MG],3500194,CDM,250,RC,,,outpatient,,,7.75,3.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
CLONAZEPAM TAB [1 MG],3500195,CDM,250,RC,,,outpatient,,,7.75,3.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
CLONIDINE PAT [0.1 MG/24H,3500196,CDM,250,RC,,,outpatient,,,66.35,33.18,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.27,20,,,percent of total billed charges,20% of total billed charges,13.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.27,20,,,percent of total billed charges,20% of total billed charges,13.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.13,65,,,percent of total billed charges,65% of total billed charges,43.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.27,53.67,
CLONIDINE PAT [0.2 MG/24H,3500197,CDM,250,RC,,,outpatient,,,111.55,55.78,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.31,20,,,percent of total billed charges,20% of total billed charges,22.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.31,20,,,percent of total billed charges,20% of total billed charges,22.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.51,65,,,percent of total billed charges,65% of total billed charges,72.51,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.31,72.51,
CLONIDINE TAB [0.1 MG],3500198,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CLONIDINE TAB [0.2 MG],3500199,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CLONIDINE TAB [0.3 MG],3500200,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CLOPIDOGREL TAB [75 MG],3501016,CDM,250,RC,,,outpatient,,,21.85,10.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.37,20,,,percent of total billed charges,20% of total billed charges,4.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.37,20,,,percent of total billed charges,20% of total billed charges,4.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,65,,,percent of total billed charges,65% of total billed charges,14.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.37,53.67,
CLORPACTIN WCS-90 [2 GR],3501024,CDM,250,RC,J3490,HCPCS,outpatient,,,15.5,7.75,,10.08,65,,,percent of total billed charges,65% of total billed charges,10.54,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.08,65,,,percent of total billed charges,65% of total billed charges,10.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.1,53.67,
CLOSED WOUND BULB,6215808,CDM,272,RC,,,outpatient,,,33.66,16.83,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.73,20,,,percent of total billed charges,20% of total billed charges,6.73,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.73,20,,,percent of total billed charges,20% of total billed charges,6.73,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.88,65,,,percent of total billed charges,65% of total billed charges,21.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.73,53.67,
CLOSTRIDIUM DIFF TOX,3300723,CDM,306,RC,87324,HCPCS,outpatient,,,110,55,,71.5,65,,,percent of total billed charges,65% of total billed charges,74.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.5,65,,,percent of total billed charges,65% of total billed charges,71.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22,74.8,
CLOTRIMAZ/ BETAMETH CRM [,3500203,CDM,250,RC,J3490,HCPCS,outpatient,,,40.5,20.25,,26.33,65,,,percent of total billed charges,65% of total billed charges,27.54,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.1,20,,,percent of total billed charges,20% of total billed charges,8.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.1,20,,,percent of total billed charges,20% of total billed charges,8.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.33,65,,,percent of total billed charges,65% of total billed charges,26.33,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,53.67,
CLOTRIMAZ/ BETAMETH LOT [,3500204,CDM,250,RC,J3490,HCPCS,outpatient,,,24.8,12.4,,16.12,65,,,percent of total billed charges,65% of total billed charges,16.86,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.96,20,,,percent of total billed charges,20% of total billed charges,4.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.96,20,,,percent of total billed charges,20% of total billed charges,4.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.12,65,,,percent of total billed charges,65% of total billed charges,16.12,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.96,53.67,
CLOTRIMAZOLE 1% CRM [15 G,3500205,CDM,250,RC,J3490,HCPCS,outpatient,,,39.9,19.95,,25.94,65,,,percent of total billed charges,65% of total billed charges,27.13,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.98,20,,,percent of total billed charges,20% of total billed charges,7.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.98,20,,,percent of total billed charges,20% of total billed charges,7.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.94,65,,,percent of total billed charges,65% of total billed charges,25.94,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.98,53.67,
CMV IGG AB,3300517,CDM,302,RC,86644,HCPCS,outpatient,,,88,44,,57.2,65,,,percent of total billed charges,65% of total billed charges,59.84,68,,,percent of total billed charges,68% of total billed charges,20.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.2,65,,,percent of total billed charges,65% of total billed charges,57.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.6,59.84,
CMV IGM AB,3300545,CDM,302,RC,86645,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,23.91,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
COBAN 2,3521940,CDM,272,RC,,,outpatient,,,114.95,57.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.99,20,,,percent of total billed charges,20% of total billed charges,22.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.99,20,,,percent of total billed charges,20% of total billed charges,22.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.72,65,,,percent of total billed charges,65% of total billed charges,74.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.99,74.72,
COBAN 2 LITE,3521941,CDM,271,RC,,,outpatient,,,114.95,57.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.99,20,,,percent of total billed charges,20% of total billed charges,22.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.99,20,,,percent of total billed charges,20% of total billed charges,22.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.72,65,,,percent of total billed charges,65% of total billed charges,74.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.99,74.72,
COCCYX/SACRUM MIN 2,3400016,CDM,320,RC,72220,HCPCS,outpatient,,,187,93.5,,121.55,65,,,percent of total billed charges,65% of total billed charges,127.16,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.4,20,,,percent of total billed charges,20% of total billed charges,37.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.4,20,,,percent of total billed charges,20% of total billed charges,37.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.55,65,,,percent of total billed charges,65% of total billed charges,121.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
COCCYX/SACRUM MIN 2V,3440043,CDM,972,RC,72220,HCPCS,outpatient,,,56.1,28.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,110,,,fee schedule,110% of Medicare physician fee schedule,35.09,110,,,fee schedule,110% of Medicare physician fee schedule,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.09,115,,,fee schedule,115% of Medicare physician fee schedule,67.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.33,213.09,
COGNITIVE SKILLS/15MIN,3600045,CDM,440,RC,G0515,HCPCS,outpatient,,,78,39,,50.7,65,,,percent of total billed charges,65% of total billed charges,53.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,20,,,percent of total billed charges,20% of total billed charges,15.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,20,,,percent of total billed charges,20% of total billed charges,15.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.7,65,,,percent of total billed charges,65% of total billed charges,50.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,82,
COL/POLYP REM SNA/CU,3060245,CDM,750,RC,45385,HCPCS,outpatient,,,1513,756.5,,983.45,65,,,percent of total billed charges,65% of total billed charges,1028.84,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.6,20,,,percent of total billed charges,20% of total billed charges,302.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.6,20,,,percent of total billed charges,20% of total billed charges,302.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,983.45,65,,,percent of total billed charges,65% of total billed charges,983.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,907.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1028.84,
COLCRYS TAB [0.6 MG],3501034,CDM,250,RC,,,outpatient,,,33.7,16.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.74,20,,,percent of total billed charges,20% of total billed charges,6.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.74,20,,,percent of total billed charges,20% of total billed charges,6.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.91,65,,,percent of total billed charges,65% of total billed charges,21.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.74,53.67,
COLD AGGLUTININS,3300481,CDM,302,RC,86156,HCPCS,outpatient,,,74,37,,48.1,65,,,percent of total billed charges,65% of total billed charges,50.32,68,,,percent of total billed charges,68% of total billed charges,9.51,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.8,20,,,percent of total billed charges,20% of total billed charges,14.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.8,20,,,percent of total billed charges,20% of total billed charges,14.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.1,65,,,percent of total billed charges,65% of total billed charges,48.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,50.32,
COLLAGENASE OINT [15 GM],3500209,CDM,250,RC,J3490,HCPCS,outpatient,,,39.85,19.93,,25.9,65,,,percent of total billed charges,65% of total billed charges,27.1,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.97,20,,,percent of total billed charges,20% of total billed charges,7.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.97,20,,,percent of total billed charges,20% of total billed charges,7.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.9,65,,,percent of total billed charges,65% of total billed charges,25.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.97,53.67,
COLN SCN; BE ALT TO CNSPY,3400204,CDM,320,RC,G0120,HCPCS,outpatient,,,318.28,159.14,,206.88,65,,,percent of total billed charges,65% of total billed charges,216.43,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.66,20,,,percent of total billed charges,20% of total billed charges,63.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.66,20,,,percent of total billed charges,20% of total billed charges,63.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,206.88,65,,,percent of total billed charges,65% of total billed charges,206.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,216.43,
COLN SCN; BE ALT TO CNSPY,3440457,CDM,972,RC,G0120,HCPCS,outpatient,,,87,43.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,95.7,110,,,fee schedule,110% of Medicare physician fee schedule,95.7,110,,,fee schedule,110% of Medicare physician fee schedule,,,,,other,Not seperately reimbursable,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,100.05,115,,,fee schedule,115% of Medicare physician fee schedule,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,95.7,110.06,
COLON DISCONTINUED,3060275,CDM,750,RC,45378,HCPCS,outpatient,,,770,385,,500.5,65,,,percent of total billed charges,65% of total billed charges,523.6,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,154,20,,,percent of total billed charges,20% of total billed charges,154,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,154,20,,,percent of total billed charges,20% of total billed charges,154,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,500.5,65,,,percent of total billed charges,65% of total billed charges,500.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,665,
COLON THRU STOMA,3060276,CDM,750,RC,44388,HCPCS,outpatient,,,1457,728.5,,947.05,65,,,percent of total billed charges,65% of total billed charges,990.76,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,291.4,20,,,percent of total billed charges,20% of total billed charges,291.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,291.4,20,,,percent of total billed charges,20% of total billed charges,291.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,947.05,65,,,percent of total billed charges,65% of total billed charges,947.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,874.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,990.76,
COLON/HIGH RISK SCRE,3060255,CDM,750,RC,G0105,HCPCS,outpatient,,,1320,660,,858,65,,,percent of total billed charges,65% of total billed charges,897.6,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,264,20,,,percent of total billed charges,20% of total billed charges,264,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,264,20,,,percent of total billed charges,20% of total billed charges,264,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,858,65,,,percent of total billed charges,65% of total billed charges,858,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,792,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,897.6,
COLON/W HOT BIOPSY STOMA,3060271,CDM,750,RC,44392,HCPCS,outpatient,,,1377,688.5,,895.05,65,,,percent of total billed charges,65% of total billed charges,936.36,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,275.4,20,,,percent of total billed charges,20% of total billed charges,275.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,275.4,20,,,percent of total billed charges,20% of total billed charges,275.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,895.05,65,,,percent of total billed charges,65% of total billed charges,895.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,826.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,936.36,
COLONOS W/BLEEDING,3060239,CDM,750,RC,45382,HCPCS,outpatient,,,1430,715,,929.5,65,,,percent of total billed charges,65% of total billed charges,972.4,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,286,20,,,percent of total billed charges,20% of total billed charges,286,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,286,20,,,percent of total billed charges,20% of total billed charges,286,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,929.5,65,,,percent of total billed charges,65% of total billed charges,929.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,858,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,972.4,
COLONOSCOP W/BIOPS-COLD PRO FEE,3461000,CDM,982,RC,45380,HCPCS,outpatient,,,1610,805,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,135.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.72,110,,,fee schedule,110% of Medicare physician fee schedule,222.72,110,,,fee schedule,110% of Medicare physician fee schedule,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,232.84,115,,,fee schedule,115% of Medicare physician fee schedule,187.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,256.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.22,256.12,
COLONOSCOP W/SNARE-PROFEE,3461020,CDM,982,RC,45385,HCPCS,outpatient,,,1690,845,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,171.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,281.73,110,,,fee schedule,110% of Medicare physician fee schedule,281.73,110,,,fee schedule,110% of Medicare physician fee schedule,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,294.54,115,,,fee schedule,115% of Medicare physician fee schedule,224.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,171.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,323.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,171.91,323.99,
COLONOSCOPY DIAGNOST,3060235,CDM,750,RC,45378,HCPCS,outpatient,,,1269,634.5,,824.85,65,,,percent of total billed charges,65% of total billed charges,862.92,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,824.85,65,,,percent of total billed charges,65% of total billed charges,824.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,862.92,
COLONOSCOPY DISCONTINUED-PROF FEE,3461050,CDM,982,RC,45378,HCPCS,outpatient,,,300,150,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.61,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,205.19,110,,,fee schedule,110% of Medicare physician fee schedule,205.19,110,,,fee schedule,110% of Medicare physician fee schedule,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.52,115,,,fee schedule,115% of Medicare physician fee schedule,177.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.61,235.97,
COLONOSCOPY-PRO FEE,3461040,CDM,982,RC,45378,HCPCS,outpatient,,,1540,770,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.61,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,205.19,110,,,fee schedule,110% of Medicare physician fee schedule,205.19,110,,,fee schedule,110% of Medicare physician fee schedule,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.52,115,,,fee schedule,115% of Medicare physician fee schedule,177.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.61,235.97,
COLONOSCOPY/BIOPSY COLD,3060237,CDM,750,RC,45380,HCPCS,outpatient,,,1267,633.5,,823.55,65,,,percent of total billed charges,65% of total billed charges,861.56,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.4,20,,,percent of total billed charges,20% of total billed charges,253.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.4,20,,,percent of total billed charges,20% of total billed charges,253.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,823.55,65,,,percent of total billed charges,65% of total billed charges,823.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,760.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,861.56,
COLONOSCOPY/SCREENIN,3060259,CDM,750,RC,G0121,HCPCS,outpatient,,,1269,634.5,,824.85,65,,,percent of total billed charges,65% of total billed charges,862.92,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,824.85,65,,,percent of total billed charges,65% of total billed charges,824.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,862.92,
COMMODE COLL SYSTEM,3250155,CDM,271,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
COMP. METABO PROFILE,3300321,CDM,301,RC,80053,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,14.61,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.61,102,
COMPLEMENT C-4 OR C3,3300525,CDM,302,RC,86160,HCPCS,outpatient,,,71,35.5,,46.15,65,,,percent of total billed charges,65% of total billed charges,48.28,68,,,percent of total billed charges,68% of total billed charges,17.04,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.15,65,,,percent of total billed charges,65% of total billed charges,46.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,48.28,
COMPLEMENT C-H (50),3300509,CDM,302,RC,86162,HCPCS,outpatient,,,118,59,,76.7,65,,,percent of total billed charges,65% of total billed charges,80.24,68,,,percent of total billed charges,68% of total billed charges,28.83,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.6,20,,,percent of total billed charges,20% of total billed charges,23.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.6,20,,,percent of total billed charges,20% of total billed charges,23.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.7,65,,,percent of total billed charges,65% of total billed charges,76.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.6,80.24,
CON X-RAY BLADDER 3+VIEW,3440471,CDM,972,RC,74430,HCPCS,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.6,110,,,fee schedule,110% of Medicare physician fee schedule,17.6,110,,,fee schedule,110% of Medicare physician fee schedule,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,194.8,115,,,fee schedule,115% of Medicare physician fee schedule,76.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.6,194.8,
CONNECTOR 5 IN 1,3250105,CDM,271,RC,,,outpatient,,,9.3,4.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.86,20,,,percent of total billed charges,20% of total billed charges,1.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.86,20,,,percent of total billed charges,20% of total billed charges,1.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.05,65,,,percent of total billed charges,65% of total billed charges,6.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.86,53.67,
CONT INHALATION TX 1ST HOUR,3170106,CDM,410,RC,94644,HCPCS,outpatient,,,600,300,,390,65,,,percent of total billed charges,65% of total billed charges,408,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,20,,,percent of total billed charges,20% of total billed charges,120,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,20,,,percent of total billed charges,20% of total billed charges,120,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,390,65,,,percent of total billed charges,65% of total billed charges,390,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,408,
CONT INHALATION TX EA ADDL HR,3170119,CDM,410,RC,94645,HCPCS,outpatient,,,189.19,94.6,,122.97,65,,,percent of total billed charges,65% of total billed charges,128.65,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.84,20,,,percent of total billed charges,20% of total billed charges,37.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.84,20,,,percent of total billed charges,20% of total billed charges,37.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.97,65,,,percent of total billed charges,65% of total billed charges,122.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.84,128.65,
CORD CLAMP,3250060,CDM,272,RC,,,outpatient,,,122.65,61.33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.53,20,,,percent of total billed charges,20% of total billed charges,24.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.53,20,,,percent of total billed charges,20% of total billed charges,24.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.72,65,,,percent of total billed charges,65% of total billed charges,79.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.53,79.72,
CORTISOL FREE URINE,3300919,CDM,301,RC,82530,HCPCS,outpatient,,,132,66,,85.8,65,,,percent of total billed charges,65% of total billed charges,89.76,68,,,percent of total billed charges,68% of total billed charges,23.72,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.4,20,,,percent of total billed charges,20% of total billed charges,26.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.4,20,,,percent of total billed charges,20% of total billed charges,26.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.8,65,,,percent of total billed charges,65% of total billed charges,85.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.72,89.76,
CORTISOL TOTAL,3300089,CDM,301,RC,82533,HCPCS,outpatient,,,83,41.5,,53.95,65,,,percent of total billed charges,65% of total billed charges,56.44,68,,,percent of total billed charges,68% of total billed charges,23.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.95,65,,,percent of total billed charges,65% of total billed charges,53.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.6,56.44,
COVID-19 RNA,3300931,CDM,306,RC,87635,HCPCS,outpatient,,,165,82.5,,107.25,65,,,percent of total billed charges,65% of total billed charges,112.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.25,65,,,percent of total billed charges,65% of total billed charges,107.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,112.2,
CPAP/BIPAP SUB,3170120,CDM,410,RC,94660,HCPCS,outpatient,,,479,239.5,,311.35,65,,,percent of total billed charges,65% of total billed charges,325.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.8,20,,,percent of total billed charges,20% of total billed charges,95.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.8,20,,,percent of total billed charges,20% of total billed charges,95.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,311.35,65,,,percent of total billed charges,65% of total billed charges,311.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,287.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,325.72,
CPAP/BIPAP-INITIAL,3170082,CDM,410,RC,94660,HCPCS,outpatient,,,589,294.5,,382.85,65,,,percent of total billed charges,65% of total billed charges,400.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117.8,20,,,percent of total billed charges,20% of total billed charges,117.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117.8,20,,,percent of total billed charges,20% of total billed charges,117.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,382.85,65,,,percent of total billed charges,65% of total billed charges,382.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,353.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,400.52,
CPK ISOENZYMES,3300091,CDM,301,RC,82552,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,19.01,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,61.2,
CPR,3170097,CDM,480,RC,92950,HCPCS,outpatient,,,531.05,265.53,,345.18,65,,,percent of total billed charges,65% of total billed charges,361.11,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.21,20,,,percent of total billed charges,20% of total billed charges,106.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.21,20,,,percent of total billed charges,20% of total billed charges,106.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,345.18,65,,,percent of total billed charges,65% of total billed charges,345.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,361.11,
CPT & PD INT,3170073,CDM,410,RC,94667,HCPCS,outpatient,,,250,125,,162.5,65,,,percent of total billed charges,65% of total billed charges,170,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,20,,,percent of total billed charges,20% of total billed charges,50,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,20,,,percent of total billed charges,20% of total billed charges,50,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.5,65,,,percent of total billed charges,65% of total billed charges,162.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,170,
CPT CHEST PD SUB,3170071,CDM,410,RC,94668,HCPCS,outpatient,,,250,125,,162.5,65,,,percent of total billed charges,65% of total billed charges,170,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,20,,,percent of total billed charges,20% of total billed charges,50,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,20,,,percent of total billed charges,20% of total billed charges,50,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.5,65,,,percent of total billed charges,65% of total billed charges,162.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,170,
CRANBERRY TAB [450 MG],3500983,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
CREAM BARRIER PROTECTOR W/ZINC,3521925,CDM,271,RC,,,outpatient,,,45.7,22.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.14,20,,,percent of total billed charges,20% of total billed charges,9.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.14,20,,,percent of total billed charges,20% of total billed charges,9.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.71,65,,,percent of total billed charges,65% of total billed charges,29.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.14,53.67,
CREATININE,3300047,CDM,301,RC,82565,HCPCS,outpatient,,,30,15,,19.5,65,,,percent of total billed charges,65% of total billed charges,20.4,68,,,percent of total billed charges,68% of total billed charges,7.27,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,20.4,
CREATININE CLEARANCE,3300093,CDM,301,RC,82575,HCPCS,outpatient,,,70,35,,45.5,65,,,percent of total billed charges,65% of total billed charges,47.6,68,,,percent of total billed charges,68% of total billed charges,13.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,65,,,percent of total billed charges,65% of total billed charges,45.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.41,47.6,
CREON / AMYLASE / LIPASE,3501134,CDM,250,RC,J3490,HCPCS,outpatient,,,21.3,10.65,,13.85,65,,,percent of total billed charges,65% of total billed charges,14.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.26,20,,,percent of total billed charges,20% of total billed charges,4.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.26,20,,,percent of total billed charges,20% of total billed charges,4.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.85,65,,,percent of total billed charges,65% of total billed charges,13.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,53.67,
CRI CARE 1ST 30-74M W/PR,3230991,CDM,450,RC,99291,HCPCS,outpatient,,,603,301.5,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,20,,,percent of total billed charges,20% of total billed charges,120.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,20,,,percent of total billed charges,20% of total billed charges,120.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,391.95,65,,,percent of total billed charges,65% of total billed charges,391.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,735,
CRIT CARE 1ST 30-74 MIN,3230989,CDM,450,RC,99291,HCPCS,outpatient,,,603,301.5,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,20,,,percent of total billed charges,20% of total billed charges,120.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,20,,,percent of total billed charges,20% of total billed charges,120.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,391.95,65,,,percent of total billed charges,65% of total billed charges,391.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,735,
CRIT CARE EA ADD 30 MIN,3230993,CDM,450,RC,99292,HCPCS,outpatient,,,160,80,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104,65,,,percent of total billed charges,65% of total billed charges,104,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32,735,
CROFAB ANTIVENOM 2PACK,3500206,CDM,636,RC,J0840,HCPCS,outpatient,,,5564.55,2782.28,,3616.96,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,3783.89,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1112.91,20,,,percent of total billed charges,20% of total billed charges,1112.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1112.91,20,,,percent of total billed charges,20% of total billed charges,1112.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4451.64,80,,,case rate,80% for high cost drug carve out,4729.87,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3338.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1112.91,4729.87,
CROSS MATCH X # UNIT,3300843,CDM,390,RC,86922,HCPCS,outpatient,,,95,47.5,,61.75,65,,,percent of total billed charges,65% of total billed charges,64.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.75,65,,,percent of total billed charges,65% of total billed charges,61.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19,64.6,
CRP  (IN HOUSE),3300924,CDM,302,RC,86140,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,7.34,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.34,54.4,
CRYOGLOBULIN,3300447,CDM,301,RC,82595,HCPCS,outpatient,,,156,78,,101.4,65,,,percent of total billed charges,65% of total billed charges,106.08,68,,,percent of total billed charges,68% of total billed charges,9.19,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,20,,,percent of total billed charges,20% of total billed charges,31.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,20,,,percent of total billed charges,20% of total billed charges,31.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,65,,,percent of total billed charges,65% of total billed charges,101.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.19,106.08,
CRYSTALS FLUID,3300793,CDM,309,RC,89060,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,10.15,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.15,46.24,
CSF ANALYSIS,3300787,CDM,309,RC,89050,HCPCS,outpatient,,,82,41,,53.3,65,,,percent of total billed charges,65% of total billed charges,55.76,68,,,percent of total billed charges,68% of total billed charges,6.71,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.4,20,,,percent of total billed charges,20% of total billed charges,16.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.4,20,,,percent of total billed charges,20% of total billed charges,16.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.3,65,,,percent of total billed charges,65% of total billed charges,53.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.71,55.76,
CT ABD & PELV 1+ SEC/REG,3420093,CDM,352,RC,74178,HCPCS,outpatient,,,4070,2035,,2645.5,65,,,percent of total billed charges,65% of total billed charges,2767.6,68,,,percent of total billed charges,68% of total billed charges,564.92,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,814,20,,,percent of total billed charges,20% of total billed charges,814,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,814,20,,,percent of total billed charges,20% of total billed charges,814,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2645.5,65,,,percent of total billed charges,65% of total billed charges,2645.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,2767.6,
CT ABD & PELV 1+SEC/REG,3440475,CDM,972,RC,74178,HCPCS,outpatient,,,711.7,355.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,380.29,110,,,fee schedule,110% of Medicare physician fee schedule,380.29,110,,,fee schedule,110% of Medicare physician fee schedule,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,796.44,115,,,fee schedule,115% of Medicare physician fee schedule,244.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,191.95,796.44,
CT ABD & PELV WI CON,3440473,CDM,972,RC,74177,HCPCS,outpatient,,,656.7,328.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,170.6,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,339.92,110,,,fee schedule,110% of Medicare physician fee schedule,339.92,110,,,fee schedule,110% of Medicare physician fee schedule,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,754.23,115,,,fee schedule,115% of Medicare physician fee schedule,223.2,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,390.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.6,754.23,
CT ABD & PELVIS  W/CONTR,3420091,CDM,352,RC,74177,HCPCS,outpatient,,,3352.8,1676.4,,2179.32,65,,,percent of total billed charges,65% of total billed charges,2279.9,68,,,percent of total billed charges,68% of total billed charges,455.96,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,670.56,20,,,percent of total billed charges,20% of total billed charges,670.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,670.56,20,,,percent of total billed charges,20% of total billed charges,670.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2179.32,65,,,percent of total billed charges,65% of total billed charges,2179.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2011.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,2279.9,
CT ABD & PELVIS W/O CONT,3420089,CDM,352,RC,74176,HCPCS,outpatient,,,2695,1347.5,,1751.75,65,,,percent of total billed charges,65% of total billed charges,1832.6,68,,,percent of total billed charges,68% of total billed charges,386.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,539,20,,,percent of total billed charges,20% of total billed charges,539,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,539,20,,,percent of total billed charges,20% of total billed charges,539,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1751.75,65,,,percent of total billed charges,65% of total billed charges,1751.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1617,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1832.6,
CT ABD &PELV W/O CON,3440477,CDM,972,RC,74176,HCPCS,outpatient,,,580.8,290.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,110.24,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,205.19,110,,,fee schedule,110% of Medicare physician fee schedule,205.19,110,,,fee schedule,110% of Medicare physician fee schedule,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,613.38,115,,,fee schedule,115% of Medicare physician fee schedule,162.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.24,613.38,
CT ABD PELV W/WO CONTRAST,3440334,CDM,972,RC,74178,HCPCS,outpatient,,,711.7,355.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,380.29,110,,,fee schedule,110% of Medicare physician fee schedule,380.29,110,,,fee schedule,110% of Medicare physician fee schedule,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,796.44,115,,,fee schedule,115% of Medicare physician fee schedule,244.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,437.34,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,191.95,796.44,
CT ABD PELV W/WO/CONTRAST,3420094,CDM,352,RC,74178,HCPCS,outpatient,,,4070,2035,,2645.5,65,,,percent of total billed charges,65% of total billed charges,2767.6,68,,,percent of total billed charges,68% of total billed charges,564.92,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,814,20,,,percent of total billed charges,20% of total billed charges,814,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,814,20,,,percent of total billed charges,20% of total billed charges,814,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2645.5,65,,,percent of total billed charges,65% of total billed charges,2645.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2442,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,2767.6,
CT ABD WI,3440329,CDM,972,RC,74160,HCPCS,outpatient,,,322,161,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,126.9,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,261.04,110,,,fee schedule,110% of Medicare physician fee schedule,261.04,110,,,fee schedule,110% of Medicare physician fee schedule,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.77,115,,,fee schedule,115% of Medicare physician fee schedule,179.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.9,671.77,
CT ABD WI/WO,3440331,CDM,972,RC,74170,HCPCS,outpatient,,,389.4,194.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,144.38,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,292.51,110,,,fee schedule,110% of Medicare physician fee schedule,292.51,110,,,fee schedule,110% of Medicare physician fee schedule,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,704.67,115,,,fee schedule,115% of Medicare physician fee schedule,196.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.38,704.67,
CT ABD WO,3440333,CDM,972,RC,74150,HCPCS,outpatient,,,300.3,150.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.56,110,,,fee schedule,110% of Medicare physician fee schedule,152.56,110,,,fee schedule,110% of Medicare physician fee schedule,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,558.35,115,,,fee schedule,115% of Medicare physician fee schedule,135.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.79,558.35,
CT ABDOMINAL WI,3420035,CDM,352,RC,74160,HCPCS,outpatient,,,1498,749,,973.7,65,,,percent of total billed charges,65% of total billed charges,1018.64,68,,,percent of total billed charges,68% of total billed charges,227.98,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,299.6,20,,,percent of total billed charges,20% of total billed charges,299.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,299.6,20,,,percent of total billed charges,20% of total billed charges,299.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,973.7,65,,,percent of total billed charges,65% of total billed charges,973.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,898.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1018.64,
CT ABDOMINAL WI/WO,3420037,CDM,352,RC,74170,HCPCS,outpatient,,,2100,1050,,1365,65,,,percent of total billed charges,65% of total billed charges,1428,68,,,percent of total billed charges,68% of total billed charges,282.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,20,,,percent of total billed charges,20% of total billed charges,420,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,20,,,percent of total billed charges,20% of total billed charges,420,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1365,65,,,percent of total billed charges,65% of total billed charges,1365,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1260,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1428,
CT ABDOMINAL WO,3420039,CDM,352,RC,74150,HCPCS,outpatient,,,950,475,,617.5,65,,,percent of total billed charges,65% of total billed charges,646,68,,,percent of total billed charges,68% of total billed charges,189,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,20,,,percent of total billed charges,20% of total billed charges,190,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,20,,,percent of total billed charges,20% of total billed charges,190,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,617.5,65,,,percent of total billed charges,65% of total billed charges,617.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,646,
CT ANGIOGRAPHY CHEST,3420079,CDM,352,RC,71275,HCPCS,outpatient,,,1050,525,,682.5,65,,,percent of total billed charges,65% of total billed charges,714,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210,20,,,percent of total billed charges,20% of total billed charges,210,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210,20,,,percent of total billed charges,20% of total billed charges,210,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,682.5,65,,,percent of total billed charges,65% of total billed charges,682.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,630,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,714,
CT CHEST LOW DOSE PRO FEE,3440490,CDM,972,RC,71271,HCPCS,outpatient,,,305.8,152.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.63,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,153.36,110,,,fee schedule,110% of Medicare physician fee schedule,153.36,110,,,fee schedule,110% of Medicare physician fee schedule,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,336.73,115,,,fee schedule,115% of Medicare physician fee schedule,146.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.63,336.73,
CT CHEST LUNG LOW DOSE SCREENING,3420086,CDM,352,RC,71271,HCPCS,outpatient,,,2600,1300,,1690,65,,,percent of total billed charges,65% of total billed charges,1768,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,20,,,percent of total billed charges,20% of total billed charges,520,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,20,,,percent of total billed charges,20% of total billed charges,520,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1690,65,,,percent of total billed charges,65% of total billed charges,1690,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1768,
CT CHEST WI,3440355,CDM,972,RC,71260,HCPCS,outpatient,,,333.3,166.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,108.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,185.61,110,,,fee schedule,110% of Medicare physician fee schedule,185.61,110,,,fee schedule,110% of Medicare physician fee schedule,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,592.91,115,,,fee schedule,115% of Medicare physician fee schedule,160.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,108.22,592.91,
CT CHEST WI/WO,3420063,CDM,352,RC,71270,HCPCS,outpatient,,,3200,1600,,2080,65,,,percent of total billed charges,65% of total billed charges,2176,68,,,percent of total billed charges,68% of total billed charges,294.28,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,640,20,,,percent of total billed charges,20% of total billed charges,640,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,640,20,,,percent of total billed charges,20% of total billed charges,640,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2080,65,,,percent of total billed charges,65% of total billed charges,2080,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1920,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,2176,
CT CHEST WI/WO,3440357,CDM,972,RC,71270,HCPCS,outpatient,,,369.6,184.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,129.55,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,218.41,110,,,fee schedule,110% of Medicare physician fee schedule,218.41,110,,,fee schedule,110% of Medicare physician fee schedule,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,627.19,115,,,fee schedule,115% of Medicare physician fee schedule,182.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,129.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,251.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,129.55,627.19,
CT CHEST WO,3420065,CDM,352,RC,71250,HCPCS,outpatient,,,2600,1300,,1690,65,,,percent of total billed charges,65% of total billed charges,1768,68,,,percent of total billed charges,68% of total billed charges,197.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,20,,,percent of total billed charges,20% of total billed charges,520,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,20,,,percent of total billed charges,20% of total billed charges,520,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1690,65,,,percent of total billed charges,65% of total billed charges,1690,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1560,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1768,
CT CHEST WO,3440359,CDM,972,RC,71250,HCPCS,outpatient,,,305.8,152.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,89.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.46,110,,,fee schedule,110% of Medicare physician fee schedule,148.46,110,,,fee schedule,110% of Medicare physician fee schedule,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,554.06,115,,,fee schedule,115% of Medicare physician fee schedule,142.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,89.91,554.06,
"CT Chest, CT (unspecified), CT Low Dose",3400304,CDM,972,RC,,,outpatient,,,305.8,152.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,
CT FACIAL W/O CONTRA,3420013,CDM,351,RC,70486,HCPCS,outpatient,,,800,400,,520,65,,,percent of total billed charges,65% of total billed charges,544,68,,,percent of total billed charges,68% of total billed charges,157.68,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,65,,,percent of total billed charges,65% of total billed charges,520,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,544,
CT FACIAL WI/WO,3420031,CDM,351,RC,70488,HCPCS,outpatient,,,1091,545.5,,709.15,65,,,percent of total billed charges,65% of total billed charges,741.88,68,,,percent of total billed charges,68% of total billed charges,235.97,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,218.2,20,,,percent of total billed charges,20% of total billed charges,218.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,218.2,20,,,percent of total billed charges,20% of total billed charges,218.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,709.15,65,,,percent of total billed charges,65% of total billed charges,709.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,654.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,741.88,
CT FACIAL WI/WO,3440385,CDM,972,RC,70488,HCPCS,outpatient,,,212,106,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,122.63,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,206.03,110,,,fee schedule,110% of Medicare physician fee schedule,206.03,110,,,fee schedule,110% of Medicare physician fee schedule,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,391.8,115,,,fee schedule,115% of Medicare physician fee schedule,175.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.63,391.8,
CT FACIAL WO CONTRAS,3440311,CDM,972,RC,70486,HCPCS,outpatient,,,239,119.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.74,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.31,110,,,fee schedule,110% of Medicare physician fee schedule,142.31,110,,,fee schedule,110% of Medicare physician fee schedule,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,547.64,115,,,fee schedule,115% of Medicare physician fee schedule,135.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.74,547.64,
CT HEAD/ BRAIN WI,3420007,CDM,351,RC,70460,HCPCS,outpatient,,,1500,750,,975,65,,,percent of total billed charges,65% of total billed charges,1020,68,,,percent of total billed charges,68% of total billed charges,189,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,975,65,,,percent of total billed charges,65% of total billed charges,975,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1020,
CT HEAD/ BRAIN WI/WO,3420009,CDM,351,RC,70470,HCPCS,outpatient,,,1600,800,,1040,65,,,percent of total billed charges,65% of total billed charges,1088,68,,,percent of total billed charges,68% of total billed charges,235.97,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,320,20,,,percent of total billed charges,20% of total billed charges,320,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,320,20,,,percent of total billed charges,20% of total billed charges,320,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1040,65,,,percent of total billed charges,65% of total billed charges,1040,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1088,
CT HEAD/ BRAIN WO,3440309,CDM,972,RC,70450,HCPCS,outpatient,,,226,113,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.01,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,118.13,110,,,fee schedule,110% of Medicare physician fee schedule,118.13,110,,,fee schedule,110% of Medicare physician fee schedule,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,522.36,115,,,fee schedule,115% of Medicare physician fee schedule,116.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.01,522.36,
CT HEAD/BRAIN WI/WO,3440307,CDM,972,RC,70470,HCPCS,outpatient,,,311,155.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,105.52,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,193.77,110,,,fee schedule,110% of Medicare physician fee schedule,193.77,110,,,fee schedule,110% of Medicare physician fee schedule,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,601.43,115,,,fee schedule,115% of Medicare physician fee schedule,158.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,105.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,222.83,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,105.52,601.43,
CT HEAD/BRAIN WO,3420011,CDM,351,RC,70450,HCPCS,outpatient,,,1100,550,,715,65,,,percent of total billed charges,65% of total billed charges,748,68,,,percent of total billed charges,68% of total billed charges,157.68,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,220,20,,,percent of total billed charges,20% of total billed charges,220,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,220,20,,,percent of total billed charges,20% of total billed charges,220,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,715,65,,,percent of total billed charges,65% of total billed charges,715,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,748,
CT KIDNEY WO CONTRAS,3440335,CDM,972,RC,74150,HCPCS,outpatient,,,300.3,150.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.56,110,,,fee schedule,110% of Medicare physician fee schedule,152.56,110,,,fee schedule,110% of Medicare physician fee schedule,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,558.35,115,,,fee schedule,115% of Medicare physician fee schedule,135.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.79,558.35,
CT KIDNEY WO/CONTRAS,3420041,CDM,352,RC,74150,HCPCS,outpatient,,,880,440,,572,65,,,percent of total billed charges,65% of total billed charges,598.4,68,,,percent of total billed charges,68% of total billed charges,189,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,176,20,,,percent of total billed charges,20% of total billed charges,176,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,176,20,,,percent of total billed charges,20% of total billed charges,176,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,572,65,,,percent of total billed charges,65% of total billed charges,572,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,528,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,598.4,
CT LIMITED,3420005,CDM,350,RC,76380,HCPCS,outpatient,,,647,323.5,,420.55,65,,,percent of total billed charges,65% of total billed charges,439.96,68,,,percent of total billed charges,68% of total billed charges,116.78,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.4,20,,,percent of total billed charges,20% of total billed charges,129.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.4,20,,,percent of total billed charges,20% of total billed charges,129.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420.55,65,,,percent of total billed charges,65% of total billed charges,420.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,388.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,439.96,
CT LIMITED,3440383,CDM,972,RC,76380,HCPCS,outpatient,,,210,105,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,66.16,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.48,110,,,fee schedule,110% of Medicare physician fee schedule,146.48,110,,,fee schedule,110% of Medicare physician fee schedule,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,551.99,115,,,fee schedule,115% of Medicare physician fee schedule,118.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,66.16,551.99,
CT LIVER W/WO CONTRAST,3420043,CDM,352,RC,74170,HCPCS,outpatient,,,1008,504,,655.2,65,,,percent of total billed charges,65% of total billed charges,685.44,68,,,percent of total billed charges,68% of total billed charges,282.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,201.6,20,,,percent of total billed charges,20% of total billed charges,201.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,201.6,20,,,percent of total billed charges,20% of total billed charges,201.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,655.2,65,,,percent of total billed charges,65% of total billed charges,655.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,604.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,685.44,
CT LIVER WI CONTRAST,3440337,CDM,972,RC,74160,HCPCS,outpatient,,,322,161,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,126.9,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,261.04,110,,,fee schedule,110% of Medicare physician fee schedule,261.04,110,,,fee schedule,110% of Medicare physician fee schedule,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.77,115,,,fee schedule,115% of Medicare physician fee schedule,179.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,300.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,126.9,671.77,
CT LOWER EXT WI,3420073,CDM,352,RC,73701,HCPCS,outpatient,,,1025,512.5,,666.25,65,,,percent of total billed charges,65% of total billed charges,697,68,,,percent of total billed charges,68% of total billed charges,197.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205,20,,,percent of total billed charges,20% of total billed charges,205,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205,20,,,percent of total billed charges,20% of total billed charges,205,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,666.25,65,,,percent of total billed charges,65% of total billed charges,666.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,697,
CT LOWER EXT WI,3440375,CDM,972,RC,73701,HCPCS,outpatient,,,200,100,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,123.82,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,185.61,110,,,fee schedule,110% of Medicare physician fee schedule,185.61,110,,,fee schedule,110% of Medicare physician fee schedule,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,592.91,115,,,fee schedule,115% of Medicare physician fee schedule,176.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,213.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.82,592.91,
CT LOWER EXT WI/WO,3420077,CDM,352,RC,73702,HCPCS,outpatient,,,1158,579,,752.7,65,,,percent of total billed charges,65% of total billed charges,787.44,68,,,percent of total billed charges,68% of total billed charges,247.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,231.6,20,,,percent of total billed charges,20% of total billed charges,231.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,231.6,20,,,percent of total billed charges,20% of total billed charges,231.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,752.7,65,,,percent of total billed charges,65% of total billed charges,752.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,694.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,787.44,
CT LOWER EXT WI/WO,3440379,CDM,972,RC,73702,HCPCS,outpatient,,,153,76.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,150.51,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.3,110,,,fee schedule,110% of Medicare physician fee schedule,168.3,110,,,fee schedule,110% of Medicare physician fee schedule,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,574.81,115,,,fee schedule,115% of Medicare physician fee schedule,203.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,150.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,150.51,574.81,
CT LOWER EXT WO,3420075,CDM,352,RC,73700,HCPCS,outpatient,,,1600,800,,1040,65,,,percent of total billed charges,65% of total billed charges,1088,68,,,percent of total billed charges,68% of total billed charges,165.51,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,320,20,,,percent of total billed charges,20% of total billed charges,320,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,320,20,,,percent of total billed charges,20% of total billed charges,320,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1040,65,,,percent of total billed charges,65% of total billed charges,1040,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1088,
CT LOWER EXT WO,3440377,CDM,972,RC,73700,HCPCS,outpatient,,,160,80,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.69,110,,,fee schedule,110% of Medicare physician fee schedule,143.69,110,,,fee schedule,110% of Medicare physician fee schedule,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,549.08,115,,,fee schedule,115% of Medicare physician fee schedule,144.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,549.08,
CT LUMBAR SPINE W,3440443,CDM,972,RC,72132,HCPCS,outpatient,,,277,138.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,125.37,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,188.2,110,,,fee schedule,110% of Medicare physician fee schedule,188.2,110,,,fee schedule,110% of Medicare physician fee schedule,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,595.61,115,,,fee schedule,115% of Medicare physician fee schedule,177.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,216.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.37,595.61,
CT LUMBAR SPINE WI,3420083,CDM,352,RC,72132,HCPCS,outpatient,,,1071,535.5,,696.15,65,,,percent of total billed charges,65% of total billed charges,728.28,68,,,percent of total billed charges,68% of total billed charges,235.97,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,214.2,20,,,percent of total billed charges,20% of total billed charges,214.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,214.2,20,,,percent of total billed charges,20% of total billed charges,214.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,696.15,65,,,percent of total billed charges,65% of total billed charges,696.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,642.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,728.28,
CT NECK W CONTRAST,3440315,CDM,972,RC,70491,HCPCS,outpatient,,,316,158,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,112.02,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,205.92,110,,,fee schedule,110% of Medicare physician fee schedule,205.92,110,,,fee schedule,110% of Medicare physician fee schedule,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,614.14,115,,,fee schedule,115% of Medicare physician fee schedule,164.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,112.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,236.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,112.02,614.14,
CT NECK WI CONTRAST,3420017,CDM,351,RC,70491,HCPCS,outpatient,,,1200,600,,780,65,,,percent of total billed charges,65% of total billed charges,816,68,,,percent of total billed charges,68% of total billed charges,189,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,240,20,,,percent of total billed charges,20% of total billed charges,240,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,240,20,,,percent of total billed charges,20% of total billed charges,240,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,780,65,,,percent of total billed charges,65% of total billed charges,780,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,720,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,816,
CT NECK WI/WO CONTRA,3420019,CDM,351,RC,70492,HCPCS,outpatient,,,1580,790,,1027,65,,,percent of total billed charges,65% of total billed charges,1074.4,68,,,percent of total billed charges,68% of total billed charges,235.97,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,316,20,,,percent of total billed charges,20% of total billed charges,316,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,316,20,,,percent of total billed charges,20% of total billed charges,316,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1027,65,,,percent of total billed charges,65% of total billed charges,1027,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,948,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1074.4,
CT NECK WI/WO CONTRA,3440317,CDM,972,RC,70492,HCPCS,outpatient,,,338,169,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,134.9,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,247.29,110,,,fee schedule,110% of Medicare physician fee schedule,247.29,110,,,fee schedule,110% of Medicare physician fee schedule,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.39,115,,,fee schedule,115% of Medicare physician fee schedule,187.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,284.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.9,657.39,
CT NECK WO CONTRAST,3420021,CDM,351,RC,70490,HCPCS,outpatient,,,750,375,,487.5,65,,,percent of total billed charges,65% of total billed charges,510,68,,,percent of total billed charges,68% of total billed charges,157.68,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,20,,,percent of total billed charges,20% of total billed charges,150,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,20,,,percent of total billed charges,20% of total billed charges,150,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,487.5,65,,,percent of total billed charges,65% of total billed charges,487.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,450,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,510,
CT NECK WO CONTRAST,3440319,CDM,972,RC,70490,HCPCS,outpatient,,,288,144,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.8,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,167.66,110,,,fee schedule,110% of Medicare physician fee schedule,167.66,110,,,fee schedule,110% of Medicare physician fee schedule,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,574.14,115,,,fee schedule,115% of Medicare physician fee schedule,145.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,192.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.8,574.14,
CT ORBITS IAC WI,3420023,CDM,351,RC,70481,HCPCS,outpatient,,,1282,641,,833.3,65,,,percent of total billed charges,65% of total billed charges,871.76,68,,,percent of total billed charges,68% of total billed charges,189,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,256.4,20,,,percent of total billed charges,20% of total billed charges,256.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,256.4,20,,,percent of total billed charges,20% of total billed charges,256.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,833.3,65,,,percent of total billed charges,65% of total billed charges,833.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,769.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,871.76,
CT ORBITS IAC WI,3440321,CDM,972,RC,70481,HCPCS,outpatient,,,315,157.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,151,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,200.97,110,,,fee schedule,110% of Medicare physician fee schedule,200.97,110,,,fee schedule,110% of Medicare physician fee schedule,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,608.97,115,,,fee schedule,115% of Medicare physician fee schedule,203.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,151,100,,,fee schedule,100% of FL Medicaid fee schedule ,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151,608.97,
CT ORBITS IAM WO,3420025,CDM,351,RC,70480,HCPCS,outpatient,,,1312,656,,852.8,65,,,percent of total billed charges,65% of total billed charges,892.16,68,,,percent of total billed charges,68% of total billed charges,157.68,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.4,20,,,percent of total billed charges,20% of total billed charges,262.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.4,20,,,percent of total billed charges,20% of total billed charges,262.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,852.8,65,,,percent of total billed charges,65% of total billed charges,852.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,787.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,892.16,
CT ORBITS IAM WO,3440323,CDM,972,RC,70480,HCPCS,outpatient,,,288,144,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,104.49,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.77,110,,,fee schedule,110% of Medicare physician fee schedule,176.77,110,,,fee schedule,110% of Medicare physician fee schedule,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,583.67,115,,,fee schedule,115% of Medicare physician fee schedule,157.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,104.49,583.67,
CT PELVIS WI,3420045,CDM,352,RC,72193,HCPCS,outpatient,,,1550,775,,1007.5,65,,,percent of total billed charges,65% of total billed charges,1054,68,,,percent of total billed charges,68% of total billed charges,227.98,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,310,20,,,percent of total billed charges,20% of total billed charges,310,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,310,20,,,percent of total billed charges,20% of total billed charges,310,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1007.5,65,,,percent of total billed charges,65% of total billed charges,1007.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,930,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1054,
CT PELVIS WI,3440339,CDM,972,RC,72193,HCPCS,outpatient,,,275,137.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,123.82,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,256.05,110,,,fee schedule,110% of Medicare physician fee schedule,256.05,110,,,fee schedule,110% of Medicare physician fee schedule,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,666.55,115,,,fee schedule,115% of Medicare physician fee schedule,176.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,294.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.82,666.55,
CT PELVIS WI/WO,3420047,CDM,352,RC,72194,HCPCS,outpatient,,,1600,800,,1040,65,,,percent of total billed charges,65% of total billed charges,1088,68,,,percent of total billed charges,68% of total billed charges,282.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,320,20,,,percent of total billed charges,20% of total billed charges,320,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,320,20,,,percent of total billed charges,20% of total billed charges,320,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1040,65,,,percent of total billed charges,65% of total billed charges,1040,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,960,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1088,
CT PELVIS WI/WO,3440341,CDM,972,RC,72194,HCPCS,outpatient,,,293,146.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,142.9,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,282.11,110,,,fee schedule,110% of Medicare physician fee schedule,282.11,110,,,fee schedule,110% of Medicare physician fee schedule,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,693.79,115,,,fee schedule,115% of Medicare physician fee schedule,195.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,324.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.9,693.79,
CT PELVIS WO,3420049,CDM,352,RC,72192,HCPCS,outpatient,,,1500,750,,975,65,,,percent of total billed charges,65% of total billed charges,1020,68,,,percent of total billed charges,68% of total billed charges,197.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,975,65,,,percent of total billed charges,65% of total billed charges,975,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1020,
CT PELVIS WO,3440343,CDM,972,RC,72192,HCPCS,outpatient,,,255,127.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.53,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.48,110,,,fee schedule,110% of Medicare physician fee schedule,148.48,110,,,fee schedule,110% of Medicare physician fee schedule,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,554.09,115,,,fee schedule,115% of Medicare physician fee schedule,133.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,80.53,554.09,
CT SACRUM WO,3440345,CDM,972,RC,72131,HCPCS,outpatient,,,277,138.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.34,110,,,fee schedule,110% of Medicare physician fee schedule,143.34,110,,,fee schedule,110% of Medicare physician fee schedule,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,548.72,115,,,fee schedule,115% of Medicare physician fee schedule,144.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,548.72,
CT SACRUM WO/CONTRAS,3420051,CDM,352,RC,72131,HCPCS,outpatient,,,1565,782.5,,1017.25,65,,,percent of total billed charges,65% of total billed charges,1064.2,68,,,percent of total billed charges,68% of total billed charges,197.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,313,20,,,percent of total billed charges,20% of total billed charges,313,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,313,20,,,percent of total billed charges,20% of total billed charges,313,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1017.25,65,,,percent of total billed charges,65% of total billed charges,1017.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,939,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1064.2,
CT SINUS WO CONTRAST,3440327,CDM,972,RC,70486,HCPCS,outpatient,,,239,119.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.74,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.31,110,,,fee schedule,110% of Medicare physician fee schedule,142.31,110,,,fee schedule,110% of Medicare physician fee schedule,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,547.64,115,,,fee schedule,115% of Medicare physician fee schedule,135.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.74,547.64,
CT SINUS WO/CONTRAST,3420029,CDM,351,RC,70486,HCPCS,outpatient,,,700,350,,455,65,,,percent of total billed charges,65% of total billed charges,476,68,,,percent of total billed charges,68% of total billed charges,157.68,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140,20,,,percent of total billed charges,20% of total billed charges,140,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140,20,,,percent of total billed charges,20% of total billed charges,140,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,455,65,,,percent of total billed charges,65% of total billed charges,455,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,476,
CT SP THORACIC WO,3440353,CDM,972,RC,72128,HCPCS,outpatient,,,303,151.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.05,110,,,fee schedule,110% of Medicare physician fee schedule,144.05,110,,,fee schedule,110% of Medicare physician fee schedule,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,549.45,115,,,fee schedule,115% of Medicare physician fee schedule,144.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,549.45,
CT SPINE CERVICAL WO,3420053,CDM,352,RC,72125,HCPCS,outpatient,,,700,350,,455,65,,,percent of total billed charges,65% of total billed charges,476,68,,,percent of total billed charges,68% of total billed charges,197.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140,20,,,percent of total billed charges,20% of total billed charges,140,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140,20,,,percent of total billed charges,20% of total billed charges,140,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,455,65,,,percent of total billed charges,65% of total billed charges,455,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,476,
CT SPINE CERVICAL WO,3440347,CDM,972,RC,72125,HCPCS,outpatient,,,276,138,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.83,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.05,110,,,fee schedule,110% of Medicare physician fee schedule,144.05,110,,,fee schedule,110% of Medicare physician fee schedule,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,549.45,115,,,fee schedule,115% of Medicare physician fee schedule,146.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.83,549.45,
CT SPINE LUMBAR WO,3420055,CDM,352,RC,72131,HCPCS,outpatient,,,825,412.5,,536.25,65,,,percent of total billed charges,65% of total billed charges,561,68,,,percent of total billed charges,68% of total billed charges,197.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,165,20,,,percent of total billed charges,20% of total billed charges,165,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,165,20,,,percent of total billed charges,20% of total billed charges,165,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,536.25,65,,,percent of total billed charges,65% of total billed charges,536.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,561,
CT SPINE LUMBAR WO,3440349,CDM,972,RC,72131,HCPCS,outpatient,,,277,138.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.34,110,,,fee schedule,110% of Medicare physician fee schedule,143.34,110,,,fee schedule,110% of Medicare physician fee schedule,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,548.72,115,,,fee schedule,115% of Medicare physician fee schedule,144.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,164.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,548.72,
CT T-SPINE W/O CONT,3420059,CDM,352,RC,72128,HCPCS,outpatient,,,950,475,,617.5,65,,,percent of total billed charges,65% of total billed charges,646,68,,,percent of total billed charges,68% of total billed charges,197.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,20,,,percent of total billed charges,20% of total billed charges,190,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,20,,,percent of total billed charges,20% of total billed charges,190,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,617.5,65,,,percent of total billed charges,65% of total billed charges,617.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,646,
CT T-SPINE WI,3420057,CDM,352,RC,72129,HCPCS,outpatient,,,975,487.5,,633.75,65,,,percent of total billed charges,65% of total billed charges,663,68,,,percent of total billed charges,68% of total billed charges,235.97,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,20,,,percent of total billed charges,20% of total billed charges,195,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,20,,,percent of total billed charges,20% of total billed charges,195,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,633.75,65,,,percent of total billed charges,65% of total billed charges,633.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,663,
CT T-SPINE WO,3440351,CDM,972,RC,72128,HCPCS,outpatient,,,200,100,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.05,110,,,fee schedule,110% of Medicare physician fee schedule,144.05,110,,,fee schedule,110% of Medicare physician fee schedule,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,549.45,115,,,fee schedule,115% of Medicare physician fee schedule,144.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,549.45,
CT THORAX WITH,3420061,CDM,352,RC,71260,HCPCS,outpatient,,,1875,937.5,,1218.75,65,,,percent of total billed charges,65% of total billed charges,1275,68,,,percent of total billed charges,68% of total billed charges,235.97,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,375,20,,,percent of total billed charges,20% of total billed charges,375,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,375,20,,,percent of total billed charges,20% of total billed charges,375,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1218.75,65,,,percent of total billed charges,65% of total billed charges,1218.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1125,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1275,
CT UPPER EXT WI,3420067,CDM,352,RC,73201,HCPCS,outpatient,,,1076,538,,699.4,65,,,percent of total billed charges,65% of total billed charges,731.68,68,,,percent of total billed charges,68% of total billed charges,197.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,215.2,20,,,percent of total billed charges,20% of total billed charges,215.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,215.2,20,,,percent of total billed charges,20% of total billed charges,215.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,699.4,65,,,percent of total billed charges,65% of total billed charges,699.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,731.68,
CT UPPER EXT WI,3440369,CDM,972,RC,73201,HCPCS,outpatient,,,200,100,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,121.89,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,110,,,fee schedule,110% of Medicare physician fee schedule,220,110,,,fee schedule,110% of Medicare physician fee schedule,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,628.86,115,,,fee schedule,115% of Medicare physician fee schedule,174.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,121.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,253,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,121.89,628.86,
CT UPPER EXT WI/WO,3420071,CDM,352,RC,73202,HCPCS,outpatient,,,1585,792.5,,1030.25,65,,,percent of total billed charges,65% of total billed charges,1077.8,68,,,percent of total billed charges,68% of total billed charges,247.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,317,20,,,percent of total billed charges,20% of total billed charges,317,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,317,20,,,percent of total billed charges,20% of total billed charges,317,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1030.25,65,,,percent of total billed charges,65% of total billed charges,1030.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,951,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1077.8,
CT UPPER EXT WI/WO,3440373,CDM,972,RC,73202,HCPCS,outpatient,,,153,76.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,152.53,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.3,110,,,fee schedule,110% of Medicare physician fee schedule,168.3,110,,,fee schedule,110% of Medicare physician fee schedule,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,574.81,115,,,fee schedule,115% of Medicare physician fee schedule,205.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.53,574.81,
CT UPPER EXT WO,3420069,CDM,352,RC,73200,HCPCS,outpatient,,,1100,550,,715,65,,,percent of total billed charges,65% of total billed charges,748,68,,,percent of total billed charges,68% of total billed charges,165.51,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,220,20,,,percent of total billed charges,20% of total billed charges,220,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,220,20,,,percent of total billed charges,20% of total billed charges,220,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,715,65,,,percent of total billed charges,65% of total billed charges,715,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,748,
CT UPPER EXT WO,3440371,CDM,972,RC,73200,HCPCS,outpatient,,,160,80,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,176,110,,,fee schedule,110% of Medicare physician fee schedule,176,110,,,fee schedule,110% of Medicare physician fee schedule,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,582.86,115,,,fee schedule,115% of Medicare physician fee schedule,144.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,202.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.09,582.86,
CTA ABDOMEN,3420090,CDM,350,RC,74175,HCPCS,outpatient,,,2046,1023,,1329.9,65,,,percent of total billed charges,65% of total billed charges,1391.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,409.2,20,,,percent of total billed charges,20% of total billed charges,409.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,409.2,20,,,percent of total billed charges,20% of total billed charges,409.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1329.9,65,,,percent of total billed charges,65% of total billed charges,1329.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1391.28,
CTA ABDOMEN-PROFEE,3440306,CDM,972,RC,74175,HCPCS,outpatient,,,580,290,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,169.07,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,341.7,110,,,fee schedule,110% of Medicare physician fee schedule,341.7,110,,,fee schedule,110% of Medicare physician fee schedule,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,756.1,115,,,fee schedule,115% of Medicare physician fee schedule,221.67,100,,,fee schedule,100% of FL Medicaid fee schedule ,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,169.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,392.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.07,756.1,
CTA ABDOMINAL AORTA,3420092,CDM,350,RC,75635,HCPCS,outpatient,,,2046,1023,,1329.9,65,,,percent of total billed charges,65% of total billed charges,1391.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,409.2,20,,,percent of total billed charges,20% of total billed charges,409.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,409.2,20,,,percent of total billed charges,20% of total billed charges,409.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1329.9,65,,,percent of total billed charges,65% of total billed charges,1329.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1391.28,
CTA ABDOMINAL AORTA-PROFEE,3440310,CDM,972,RC,74150,HCPCS,outpatient,,,580,290,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.56,110,,,fee schedule,110% of Medicare physician fee schedule,152.56,110,,,fee schedule,110% of Medicare physician fee schedule,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,558.35,115,,,fee schedule,115% of Medicare physician fee schedule,135.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,175.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.79,558.35,
CTA HEAD,3420082,CDM,351,RC,70496,HCPCS,outpatient,,,2046,1023,,1329.9,65,,,percent of total billed charges,65% of total billed charges,1391.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,409.2,20,,,percent of total billed charges,20% of total billed charges,409.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,409.2,20,,,percent of total billed charges,20% of total billed charges,409.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1329.9,65,,,percent of total billed charges,65% of total billed charges,1329.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1391.28,
CTA HEAD-PROFEE,3440308,CDM,972,RC,70496,HCPCS,outpatient,,,580,290,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,195.45,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,307.56,110,,,fee schedule,110% of Medicare physician fee schedule,307.56,110,,,fee schedule,110% of Medicare physician fee schedule,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,720.4,115,,,fee schedule,115% of Medicare physician fee schedule,248.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,195.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.69,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,195.45,720.4,
CTA LUNG PE,3440381,CDM,972,RC,71275,HCPCS,outpatient,,,468.6,234.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,165.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.32,110,,,fee schedule,110% of Medicare physician fee schedule,313.32,110,,,fee schedule,110% of Medicare physician fee schedule,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,726.43,115,,,fee schedule,115% of Medicare physician fee schedule,217.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,360.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,165.22,726.43,
CTA LWR EXT BIL,3420081,CDM,352,RC,73706,HCPCS,outpatient,,,1076,538,,699.4,65,,,percent of total billed charges,65% of total billed charges,731.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,215.2,20,,,percent of total billed charges,20% of total billed charges,215.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,215.2,20,,,percent of total billed charges,20% of total billed charges,215.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,699.4,65,,,percent of total billed charges,65% of total billed charges,699.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,645.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,731.68,
CTA LWR EXT BIL,3440441,CDM,972,RC,73706,HCPCS,outpatient,,,220,110,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,189,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,242,110,,,fee schedule,110% of Medicare physician fee schedule,242,110,,,fee schedule,110% of Medicare physician fee schedule,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,651.86,115,,,fee schedule,115% of Medicare physician fee schedule,241.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,189,100,,,fee schedule,100% of FL Medicaid fee schedule ,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,278.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189,651.86,
CTA NECK,3420096,CDM,351,RC,70498,HCPCS,outpatient,,,2046,1023,,1329.9,65,,,percent of total billed charges,65% of total billed charges,1391.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,409.2,20,,,percent of total billed charges,20% of total billed charges,409.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,409.2,20,,,percent of total billed charges,20% of total billed charges,409.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1329.9,65,,,percent of total billed charges,65% of total billed charges,1329.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,407,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1227.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1391.28,
CTA NECK PRO FEE,3440485,CDM,972,RC,70498,HCPCS,outpatient,,,580,290,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,196.47,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,307.21,110,,,fee schedule,110% of Medicare physician fee schedule,307.21,110,,,fee schedule,110% of Medicare physician fee schedule,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,720.03,115,,,fee schedule,115% of Medicare physician fee schedule,249.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,196.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,353.29,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,196.47,720.03,
CTHEAD/ BRAIN WI,3440305,CDM,972,RC,70460,HCPCS,outpatient,,,284,142,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,90.12,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,164.68,110,,,fee schedule,110% of Medicare physician fee schedule,164.68,110,,,fee schedule,110% of Medicare physician fee schedule,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,571.03,115,,,fee schedule,115% of Medicare physician fee schedule,142.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,90.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,90.12,571.03,
CULTURE ENT/OTHER,3300705,CDM,306,RC,87070,HCPCS,outpatient,,,57,28.5,,37.05,65,,,percent of total billed charges,65% of total billed charges,38.76,68,,,percent of total billed charges,68% of total billed charges,12.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,38.76,
CULTURE HERPES,3300715,CDM,306,RC,87207,HCPCS,outpatient,,,105,52.5,,68.25,65,,,percent of total billed charges,65% of total billed charges,71.4,68,,,percent of total billed charges,68% of total billed charges,8.5,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,20,,,percent of total billed charges,20% of total billed charges,21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,20,,,percent of total billed charges,20% of total billed charges,21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.25,65,,,percent of total billed charges,65% of total billed charges,68.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.5,71.4,
CULTURE STOOL,3300719,CDM,306,RC,87045,HCPCS,outpatient,,,95,47.5,,61.75,65,,,percent of total billed charges,65% of total billed charges,64.6,68,,,percent of total billed charges,68% of total billed charges,13.39,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.75,65,,,percent of total billed charges,65% of total billed charges,61.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.39,64.6,
CULTURE URINE,3300691,CDM,306,RC,87086,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,11.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,40.8,
CULTURE VIRAL,3300725,CDM,306,RC,87252,HCPCS,outpatient,,,220,110,,143,65,,,percent of total billed charges,65% of total billed charges,149.6,68,,,percent of total billed charges,68% of total billed charges,37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37,149.6,
"Culture/Ent, SO",3300903,CDM,306,RC,87070,HCPCS,outpatient,,,57,28.5,,37.05,65,,,percent of total billed charges,65% of total billed charges,38.76,68,,,percent of total billed charges,68% of total billed charges,12.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,38.76,
CUT DOWN,3020025,CDM,360,RC,,,outpatient,,,280,140,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,65,,,percent of total billed charges,65% of total billed charges,182,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,182,
CYCLOBENZAPRINE TAB [10 M,3500211,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
CYCLOSPORINE,3300179,CDM,301,RC,80158,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,24.05,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.05,102,
CYPROHEPTADINE TAB  [4 MG,3500214,CDM,250,RC,J3490,HCPCS,outpatient,,,5.35,2.68,,3.48,65,,,percent of total billed charges,65% of total billed charges,3.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.07,20,,,percent of total billed charges,20% of total billed charges,1.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.07,20,,,percent of total billed charges,20% of total billed charges,1.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.48,65,,,percent of total billed charges,65% of total billed charges,3.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.07,53.67,
CYSTO BLADDER IRRIGATION SET,3250692,CDM,272,RC,,,outpatient,,,29.6,14.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.92,20,,,percent of total billed charges,20% of total billed charges,5.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.92,20,,,percent of total billed charges,20% of total billed charges,5.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.24,65,,,percent of total billed charges,65% of total billed charges,19.24,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.92,53.67,
CYSTOGRAM,3440399,CDM,972,RC,74430,HCPCS,outpatient,,,303,151.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.73,110,,,fee schedule,110% of Medicare physician fee schedule,44.73,110,,,fee schedule,110% of Medicare physician fee schedule,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,223.16,115,,,fee schedule,115% of Medicare physician fee schedule,76.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,23.71,223.16,
CYSTOGRAM INJ,3440423,CDM,972,RC,51600,HCPCS,outpatient,,,110,55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.54,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.07,110,,,fee schedule,110% of Medicare physician fee schedule,49.07,110,,,fee schedule,110% of Medicare physician fee schedule,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.3,115,,,fee schedule,115% of Medicare physician fee schedule,82.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.54,82.14,
CYSTOGRAM INJECTION,3400131,CDM,361,RC,51600,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,312,
CYSTOGRAM MIN 3VW,3400116,CDM,320,RC,74430,HCPCS,outpatient,,,475,237.5,,308.75,65,,,percent of total billed charges,65% of total billed charges,323,68,,,percent of total billed charges,68% of total billed charges,35.31,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95,20,,,percent of total billed charges,20% of total billed charges,95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95,20,,,percent of total billed charges,20% of total billed charges,95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,308.75,65,,,percent of total billed charges,65% of total billed charges,308.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,285,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.31,323,
CYTOLOGY,3300839,CDM,311,RC,88112,HCPCS,outpatient,,,93,46.5,,60.45,65,,,percent of total billed charges,65% of total billed charges,63.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.45,65,,,percent of total billed charges,65% of total billed charges,60.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,63.24,
CYTOPATHOLOGY,3300823,CDM,310,RC,88108,HCPCS,outpatient,,,93,46.5,,60.45,65,,,percent of total billed charges,65% of total billed charges,63.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.45,65,,,percent of total billed charges,65% of total billed charges,60.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,63.24,
D-DIMER QUANT,3300679,CDM,305,RC,85378,HCPCS,outpatient,,,125,62.5,,81.25,65,,,percent of total billed charges,65% of total billed charges,85,68,,,percent of total billed charges,68% of total billed charges,10.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,20,,,percent of total billed charges,20% of total billed charges,25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,20,,,percent of total billed charges,20% of total billed charges,25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.25,65,,,percent of total billed charges,65% of total billed charges,81.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.12,85,
DANTROLENE INJ [20 MG],3500217,CDM,636,RC,J3490,HCPCS,outpatient,,,425.5,212.75,,,,,,other,Not reimbursable per contract ,289.34,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.1,20,,,percent of total billed charges,20% of total billed charges,85.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.1,20,,,percent of total billed charges,20% of total billed charges,85.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,340.4,80,,,case rate,80% for high cost drug carve out,361.68,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.1,361.68,
DAPTOMYCIN 500 MG VIAL,3501140,CDM,636,RC,J0878,HCPCS,outpatient,,,744,372,,483.6,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,505.92,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.8,20,,,percent of total billed charges,20% of total billed charges,148.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.8,20,,,percent of total billed charges,20% of total billed charges,148.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,595.2,80,,,case rate,80% for high cost drug carve out,632.4,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,446.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.8,632.4,
DAT,3300783,CDM,309,RC,86880,HCPCS,outpatient,,,51,25.5,,33.15,65,,,percent of total billed charges,65% of total billed charges,34.68,68,,,percent of total billed charges,68% of total billed charges,7.62,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.62,34.68,
DEB BONE  20 SQ CM/<,3700303,CDM,983,RC,11044,HCPCS,outpatient,,,742,371,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,152.3,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,255.26,110,,,fee schedule,110% of Medicare physician fee schedule,255.26,110,,,fee schedule,110% of Medicare physician fee schedule,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,266.86,115,,,fee schedule,115% of Medicare physician fee schedule,204.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,293.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.3,293.54,
DEB BONE  20 SQ CM/<,3700304,CDM,510,RC,11044,HCPCS,outpatient,,,854,427,,555.1,65,,,percent of total billed charges,65% of total billed charges,580.72,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.8,20,,,percent of total billed charges,20% of total billed charges,170.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.8,20,,,percent of total billed charges,20% of total billed charges,170.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,555.1,65,,,percent of total billed charges,65% of total billed charges,555.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,512.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,580.72,
DEB BONE ADD-ON,3700305,CDM,983,RC,11047,HCPCS,outpatient,,,325,162.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,65.76,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.25,110,,,fee schedule,110% of Medicare physician fee schedule,111.25,110,,,fee schedule,110% of Medicare physician fee schedule,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.31,115,,,fee schedule,115% of Medicare physician fee schedule,118.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.76,127.94,
DEB BONE ADD-ON,3700308,CDM,510,RC,11047,HCPCS,outpatient,,,418,209,,271.7,65,,,percent of total billed charges,65% of total billed charges,284.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.6,20,,,percent of total billed charges,20% of total billed charges,83.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.6,20,,,percent of total billed charges,20% of total billed charges,83.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,271.7,65,,,percent of total billed charges,65% of total billed charges,271.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,284.24,
DEB MUSCLE 20 SQ CM/<,3700299,CDM,983,RC,11043,HCPCS,outpatient,,,504,252,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,104.07,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,173.09,110,,,fee schedule,110% of Medicare physician fee schedule,173.09,110,,,fee schedule,110% of Medicare physician fee schedule,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,180.95,115,,,fee schedule,115% of Medicare physician fee schedule,156.67,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,199.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,104.07,199.05,
DEB MUSCLE 20 SQ CM/<,3700300,CDM,510,RC,11043,HCPCS,outpatient,,,731,365.5,,475.15,65,,,percent of total billed charges,65% of total billed charges,497.08,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.2,20,,,percent of total billed charges,20% of total billed charges,146.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.2,20,,,percent of total billed charges,20% of total billed charges,146.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,475.15,65,,,percent of total billed charges,65% of total billed charges,475.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,438.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,497.08,
DEB MUSCLE ADD-ON 20 SQ CM,3700301,CDM,510,RC,11046,HCPCS,outpatient,,,250,125,,162.5,65,,,percent of total billed charges,65% of total billed charges,170,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,20,,,percent of total billed charges,20% of total billed charges,50,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,20,,,percent of total billed charges,20% of total billed charges,50,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.5,65,,,percent of total billed charges,65% of total billed charges,162.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,178,
DEB MUSCLE ADD-ON 20 SQ CM,3700302,CDM,983,RC,11046,HCPCS,outpatient,,,185,92.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.61,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.68,110,,,fee schedule,110% of Medicare physician fee schedule,62.68,110,,,fee schedule,110% of Medicare physician fee schedule,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.53,115,,,fee schedule,115% of Medicare physician fee schedule,90.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.61,90.21,
DEB SUBQ TISSUE 20 SQCM/<,3700287,CDM,510,RC,11042,HCPCS,outpatient,,,385,192.5,,250.25,65,,,percent of total billed charges,65% of total billed charges,261.8,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77,20,,,percent of total billed charges,20% of total billed charges,77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77,20,,,percent of total billed charges,20% of total billed charges,77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.25,65,,,percent of total billed charges,65% of total billed charges,250.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,231,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,419,
DEB SUBQ TISSUE ADD-ON,3700286,CDM,510,RC,11045,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,178,
DEBRIDE ADD-ON 20 CM/<,3700298,CDM,983,RC,97598,HCPCS,outpatient,,,88,44,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,8.51,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,27.83,110,,,fee schedule,110% of Medicare physician fee schedule,27.83,110,,,fee schedule,110% of Medicare physician fee schedule,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.1,115,,,fee schedule,115% of Medicare physician fee schedule,61.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,8.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,8.51,61.11,
DEBRIDE DEVITAL TIS 20 CM/<,3700296,CDM,510,RC,97597,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,178,
DEBRIDE DEVITAL TIS ADDL 20CM/<,3700297,CDM,510,RC,97598,HCPCS,outpatient,,,151,75.5,,98.15,65,,,percent of total billed charges,65% of total billed charges,102.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.2,20,,,percent of total billed charges,20% of total billed charges,30.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.2,20,,,percent of total billed charges,20% of total billed charges,30.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98.15,65,,,percent of total billed charges,65% of total billed charges,98.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.2,178,
DEBRIDEMENT 1ST 20CM OR LESS,3060400,CDM,361,RC,97597,HCPCS,outpatient,,,338,169,,219.7,65,,,percent of total billed charges,65% of total billed charges,229.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.6,20,,,percent of total billed charges,20% of total billed charges,67.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.6,20,,,percent of total billed charges,20% of total billed charges,67.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,219.7,65,,,percent of total billed charges,65% of total billed charges,219.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,202.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,229.84,
DEBRIDEMENT ADDITIONAL 20 CM,3060403,CDM,360,RC,11045,HCPCS,outpatient,,,950,475,,617.5,65,,,percent of total billed charges,65% of total billed charges,646,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,20,,,percent of total billed charges,20% of total billed charges,190,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,20,,,percent of total billed charges,20% of total billed charges,190,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,617.5,65,,,percent of total billed charges,65% of total billed charges,617.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,570,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,646,
DEBRIDEMENT ADDITIONAL 20CM,3060401,CDM,361,RC,97598,HCPCS,outpatient,,,165,82.5,,107.25,65,,,percent of total billed charges,65% of total billed charges,112.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.25,65,,,percent of total billed charges,65% of total billed charges,107.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,178,
DEBRIDEMENT ALL KIND,3020021,CDM,360,RC,16020,HCPCS,outpatient,,,280,140,,182,65,,,percent of total billed charges,65% of total billed charges,190.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,65,,,percent of total billed charges,65% of total billed charges,182,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,190.4,
DEBRIDEMENT BONE  20 SQCM/<,3060406,CDM,360,RC,11044,HCPCS,outpatient,,,1400,700,,910,65,,,percent of total billed charges,65% of total billed charges,952,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,280,20,,,percent of total billed charges,20% of total billed charges,280,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,280,20,,,percent of total billed charges,20% of total billed charges,280,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,910,65,,,percent of total billed charges,65% of total billed charges,910,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,840,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,952,
DEBRIDEMENT BONE EACH ADDL 20 SQ CM,3060407,CDM,360,RC,11047,HCPCS,outpatient,,,457,228.5,,297.05,65,,,percent of total billed charges,65% of total billed charges,310.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.4,20,,,percent of total billed charges,20% of total billed charges,91.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.4,20,,,percent of total billed charges,20% of total billed charges,91.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,297.05,65,,,percent of total billed charges,65% of total billed charges,297.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,274.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,310.76,
DEBRIDEMENT DEVITAL TIS 20 CM/<,3700295,CDM,983,RC,97597,HCPCS,outpatient,,,175,87.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.12,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.66,110,,,fee schedule,110% of Medicare physician fee schedule,39.66,110,,,fee schedule,110% of Medicare physician fee schedule,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.46,115,,,fee schedule,115% of Medicare physician fee schedule,70.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.12,70.72,
DEBRIDEMENT MUSCLE FASCIA 20 SQ CM/<,3060404,CDM,360,RC,11043,HCPCS,outpatient,,,841,420.5,,546.65,65,,,percent of total billed charges,65% of total billed charges,571.88,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168.2,20,,,percent of total billed charges,20% of total billed charges,168.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168.2,20,,,percent of total billed charges,20% of total billed charges,168.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,546.65,65,,,percent of total billed charges,65% of total billed charges,546.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,504.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,571.88,
DEBRIDEMENT MUSCLE/FASCIA ADDL 20 SQ CM,3060405,CDM,360,RC,11046,HCPCS,outpatient,,,273,136.5,,177.45,65,,,percent of total billed charges,65% of total billed charges,185.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,20,,,percent of total billed charges,20% of total billed charges,54.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,20,,,percent of total billed charges,20% of total billed charges,54.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.45,65,,,percent of total billed charges,65% of total billed charges,177.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,185.64,
DEBRIDEMENT NAIL ANY METHOD 1-5,3060408,CDM,360,RC,11720,HCPCS,outpatient,,,161.06,80.53,,104.69,65,,,percent of total billed charges,65% of total billed charges,109.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.21,20,,,percent of total billed charges,20% of total billed charges,32.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.21,20,,,percent of total billed charges,20% of total billed charges,32.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104.69,65,,,percent of total billed charges,65% of total billed charges,104.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.21,178,
DEBRIDEMENT NAIL ANY METHOD 6 OR MORE,3060409,CDM,360,RC,11721,HCPCS,outpatient,,,271.71,135.86,,176.61,65,,,percent of total billed charges,65% of total billed charges,184.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.34,20,,,percent of total billed charges,20% of total billed charges,54.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.34,20,,,percent of total billed charges,20% of total billed charges,54.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,176.61,65,,,percent of total billed charges,65% of total billed charges,176.61,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,163.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,184.76,
DEBRIDEMENT OPEN WOUND 20 SQCM /<,3462081,CDM,982,RC,97597,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.12,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.66,110,,,fee schedule,110% of Medicare physician fee schedule,39.66,110,,,fee schedule,110% of Medicare physician fee schedule,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.46,115,,,fee schedule,115% of Medicare physician fee schedule,70.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.12,70.72,
DEBRIDEMENT SUBCU ADDL 20 CM PF,3700275,CDM,983,RC,11045,HCPCS,outpatient,,,220,110,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.77,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.92,110,,,fee schedule,110% of Medicare physician fee schedule,28.92,110,,,fee schedule,110% of Medicare physician fee schedule,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.23,115,,,fee schedule,115% of Medicare physician fee schedule,70.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.77,70.37,
DEBRIDEMENT SUBCU TISS ADD ON 20 CM,3462006,CDM,982,RC,11045,HCPCS,outpatient,,,310,155,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.77,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.92,110,,,fee schedule,110% of Medicare physician fee schedule,28.92,110,,,fee schedule,110% of Medicare physician fee schedule,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.23,115,,,fee schedule,115% of Medicare physician fee schedule,70.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.77,70.37,
DEBRIDEMENT SUBCUTANEOUS 1ST 20 CM OR <,3060402,CDM,361,RC,11042,HCPCS,outpatient,,,700,350,,455,65,,,percent of total billed charges,65% of total billed charges,476,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140,20,,,percent of total billed charges,20% of total billed charges,140,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140,20,,,percent of total billed charges,20% of total billed charges,140,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,455,65,,,percent of total billed charges,65% of total billed charges,455,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,476,
DEBRIDEMENT SUBCUTANEOUS 1ST 20CM/< PF,3700274,CDM,983,RC,11042,HCPCS,outpatient,,,205,102.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.61,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.56,110,,,fee schedule,110% of Medicare physician fee schedule,66.56,110,,,fee schedule,110% of Medicare physician fee schedule,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.59,115,,,fee schedule,115% of Medicare physician fee schedule,93.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.61,93.21,
DEBRIDEMENT SUBCUTANEOUS 1ST CM/<,3462005,CDM,982,RC,11042,HCPCS,outpatient,,,405,202.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.61,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.56,110,,,fee schedule,110% of Medicare physician fee schedule,66.56,110,,,fee schedule,110% of Medicare physician fee schedule,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.59,115,,,fee schedule,115% of Medicare physician fee schedule,93.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.61,93.21,
DECUB CHEST,3400126,CDM,324,RC,71035,HCPCS,outpatient,,,147,73.5,,95.55,65,,,percent of total billed charges,65% of total billed charges,99.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.4,20,,,percent of total billed charges,20% of total billed charges,29.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.4,20,,,percent of total billed charges,20% of total billed charges,29.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.55,65,,,percent of total billed charges,65% of total billed charges,95.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,180,
DECUBITUS CHEST,3440045,CDM,972,RC,71035,HCPCS,outpatient,,,46,23,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,176.4,100,,,case rate,100% of case rate fee,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,176.4,
DEEP SEA NASAL SPRAY,3501149,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DEFIBRILLATOR,3250091,CDM,271,RC,,,outpatient,,,30.05,15.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.01,20,,,percent of total billed charges,20% of total billed charges,6.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.01,20,,,percent of total billed charges,20% of total billed charges,6.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.53,65,,,percent of total billed charges,65% of total billed charges,19.53,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.01,53.67,
DELIVERY OF PLACENTA,3231129,CDM,450,RC,59414,HCPCS,outpatient,,,1684,842,,1094.6,65,,,percent of total billed charges,65% of total billed charges,1145.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,336.8,20,,,percent of total billed charges,20% of total billed charges,336.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,336.8,20,,,percent of total billed charges,20% of total billed charges,336.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1094.6,65,,,percent of total billed charges,65% of total billed charges,1094.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1478,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1478,
DEMEROL,3300371,CDM,301,RC,83925,HCPCS,outpatient,,,72,36,,46.8,65,,,percent of total billed charges,65% of total billed charges,48.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,65,,,percent of total billed charges,65% of total billed charges,46.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,48.96,
DENOSUMAB 60MG/ML,5000000,CDM,636,RC,J0897,HCPCS,outpatient,,,2225.1,1112.55,,1446.32,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,1513.07,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,445.02,20,,,percent of total billed charges,20% of total billed charges,445.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,445.02,20,,,percent of total billed charges,20% of total billed charges,445.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1780.08,80,,,case rate,80% for high cost drug carve out,1891.34,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1335.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,445.02,1891.34,
DERMABOND MINI,3250666,CDM,272,RC,,,outpatient,,,62.5,31.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,20,,,percent of total billed charges,20% of total billed charges,12.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,20,,,percent of total billed charges,20% of total billed charges,12.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.63,65,,,percent of total billed charges,65% of total billed charges,40.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.5,53.67,
DERMABOND SURGICAL 0.7 ML,6215851,CDM,272,RC,,,outpatient,,,95.3,47.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.06,20,,,percent of total billed charges,20% of total billed charges,19.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.06,20,,,percent of total billed charges,20% of total billed charges,19.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.95,65,,,percent of total billed charges,65% of total billed charges,61.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.06,61.95,
DERMANET WOUND CONTACT LAYER,3250685,CDM,272,RC,,,outpatient,,,16.7,8.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.34,20,,,percent of total billed charges,20% of total billed charges,3.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.34,20,,,percent of total billed charges,20% of total billed charges,3.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.86,65,,,percent of total billed charges,65% of total billed charges,10.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.34,53.67,
DESIPRAMINE,3300265,CDM,301,RC,80160,HCPCS,outpatient,,,100,50,,65,65,,,percent of total billed charges,65% of total billed charges,68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,65,,,percent of total billed charges,65% of total billed charges,65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20,68,
DESMOPRESSIN 4 MCG/1 ML,3500219,CDM,636,RC,J2597,HCPCS,outpatient,,,317.5,158.75,,,,,,other,Not reimbursable per contract ,215.9,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.5,20,,,percent of total billed charges,20% of total billed charges,63.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.5,20,,,percent of total billed charges,20% of total billed charges,63.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,254,80,,,case rate,80% for high cost drug carve out,269.88,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.5,269.88,
DESTRUCTION PREMALIGNANT LESION 1,3462058,CDM,982,RC,17000,HCPCS,outpatient,,,93,46.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.38,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.62,110,,,fee schedule,110% of Medicare physician fee schedule,59.62,110,,,fee schedule,110% of Medicare physician fee schedule,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.33,115,,,fee schedule,115% of Medicare physician fee schedule,88.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.38,88.98,
DEXAMETHASONE 6MG TABLETS,3521947,CDM,250,RC,,,outpatient,,,8.95,4.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.79,20,,,percent of total billed charges,20% of total billed charges,1.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.79,20,,,percent of total billed charges,20% of total billed charges,1.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.82,65,,,percent of total billed charges,65% of total billed charges,5.82,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.79,53.67,
DEXAMETHASONE INJ [10 MG/,3500220,CDM,636,RC,J1094,HCPCS,outpatient,,,33.8,16.9,,,,,,other,Not reimbursable per contract ,22.98,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.76,20,,,percent of total billed charges,20% of total billed charges,6.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.76,20,,,percent of total billed charges,20% of total billed charges,6.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.04,80,,,case rate,80% for high cost drug carve out,28.73,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.76,28.73,
DEXAMETHASONE INJ [4 MG/M,3500221,CDM,636,RC,J1100,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
DEXAMETHASONE INJ [4 MG/M,3500222,CDM,636,RC,J1100,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
DEXAMETHASONE LIQ [1 MG/1,3500968,CDM,250,RC,J3490,HCPCS,outpatient,,,26.85,13.43,,17.45,65,,,percent of total billed charges,65% of total billed charges,18.26,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.37,20,,,percent of total billed charges,20% of total billed charges,5.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.37,20,,,percent of total billed charges,20% of total billed charges,5.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.45,65,,,percent of total billed charges,65% of total billed charges,17.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,53.67,
DEXAMETHASONE TAB [4 MG],3500223,CDM,250,RC,J3490,HCPCS,outpatient,,,6.05,3.03,,3.93,65,,,percent of total billed charges,65% of total billed charges,4.11,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.21,20,,,percent of total billed charges,20% of total billed charges,1.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.21,20,,,percent of total billed charges,20% of total billed charges,1.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.93,65,,,percent of total billed charges,65% of total billed charges,3.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.21,53.67,
DEXMEDETOMIDINE 100 MG/ML,3501267,CDM,636,RC,J3490,HCPCS,outpatient,,,51.55,25.78,,,,,,other,Not reimbursable per contract ,35.05,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.31,20,,,percent of total billed charges,20% of total billed charges,10.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.31,20,,,percent of total billed charges,20% of total billed charges,10.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.24,80,,,case rate,80% for high cost drug carve out,43.82,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.31,43.82,
DEXTRAN 70 OPTH  [0.1%],3500224,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DEXTROSE 25% INJ SYR [10,3500225,CDM,250,RC,,,outpatient,,,49.4,24.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.88,20,,,percent of total billed charges,20% of total billed charges,9.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.88,20,,,percent of total billed charges,20% of total billed charges,9.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.11,65,,,percent of total billed charges,65% of total billed charges,32.11,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.88,53.67,
DEXTROSE 40% GEL,3500226,CDM,250,RC,J3490,HCPCS,outpatient,,,19.75,9.88,,12.84,65,,,percent of total billed charges,65% of total billed charges,13.43,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.95,20,,,percent of total billed charges,20% of total billed charges,3.95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.95,20,,,percent of total billed charges,20% of total billed charges,3.95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.84,65,,,percent of total billed charges,65% of total billed charges,12.84,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.95,53.67,
DEXTROSE 50% INJ SYR [50,3500227,CDM,250,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
DHEA SULFATE,3300229,CDM,301,RC,82627,HCPCS,outpatient,,,145,72.5,,94.25,65,,,percent of total billed charges,65% of total billed charges,98.6,68,,,percent of total billed charges,68% of total billed charges,31.56,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,20,,,percent of total billed charges,20% of total billed charges,29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,20,,,percent of total billed charges,20% of total billed charges,29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.25,65,,,percent of total billed charges,65% of total billed charges,94.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29,98.6,
DIANEAL 2000ML,3250569,CDM,272,RC,,,outpatient,,,217.7,108.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.54,20,,,percent of total billed charges,20% of total billed charges,43.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.54,20,,,percent of total billed charges,20% of total billed charges,43.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.51,65,,,percent of total billed charges,65% of total billed charges,141.51,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.54,141.51,
DIAPERS TODDLER LG,3250053,CDM,271,RC,,,outpatient,,,14.45,7.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.89,20,,,percent of total billed charges,20% of total billed charges,2.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.89,20,,,percent of total billed charges,20% of total billed charges,2.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.39,65,,,percent of total billed charges,65% of total billed charges,9.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.89,53.67,
DIATHERIX-SARS-CoV-2 COVID-19,3300904,CDM,306,RC,87635,HCPCS,outpatient,,,483.87,241.94,,314.52,65,,,percent of total billed charges,65% of total billed charges,329.03,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.77,20,,,percent of total billed charges,20% of total billed charges,96.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.77,20,,,percent of total billed charges,20% of total billed charges,96.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,314.52,65,,,percent of total billed charges,65% of total billed charges,314.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.94,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,290.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.77,329.03,
DIAZEPAM INJ SYR [10 MG/2,3500228,CDM,636,RC,J3360,HCPCS,outpatient,,,147.7,73.85,,,,,,other,Not reimbursable per contract ,100.44,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.54,20,,,percent of total billed charges,20% of total billed charges,29.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.54,20,,,percent of total billed charges,20% of total billed charges,29.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,118.16,80,,,case rate,80% for high cost drug carve out,125.55,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.54,125.55,
DIAZEPAM TAB [5 MG],3500229,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
DICYCLOMINE CAP [10 MG],3500230,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DICYCLOMINE INJ [20 MG/2,3500231,CDM,636,RC,J0500,HCPCS,outpatient,,,210.6,105.3,,,,,,other,Not reimbursable per contract ,143.21,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,20,,,percent of total billed charges,20% of total billed charges,42.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,20,,,percent of total billed charges,20% of total billed charges,42.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168.48,80,,,case rate,80% for high cost drug carve out,179.01,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,179.01,
DICYCLOMINE TAB [20 MG],3500232,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DIFFERENTIAL SMEAR,3300643,CDM,305,RC,85007,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,4.89,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,17,
DIGITOXIN LEVEL,3300095,CDM,301,RC,80299,HCPCS,outpatient,,,85,42.5,,55.25,65,,,percent of total billed charges,65% of total billed charges,57.8,68,,,percent of total billed charges,68% of total billed charges,19.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.25,65,,,percent of total billed charges,65% of total billed charges,55.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17,57.8,
DIGOXIN INJ [0.25 MG/ML -,3500233,CDM,636,RC,J1160,HCPCS,outpatient,,,29.7,14.85,,,,,,other,Not reimbursable per contract ,20.2,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.94,20,,,percent of total billed charges,20% of total billed charges,5.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.94,20,,,percent of total billed charges,20% of total billed charges,5.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.76,80,,,case rate,80% for high cost drug carve out,25.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.94,25.25,
DIGOXIN LEVEL,3300097,CDM,301,RC,80162,HCPCS,outpatient,,,71.5,35.75,,46.48,65,,,percent of total billed charges,65% of total billed charges,48.62,68,,,percent of total billed charges,68% of total billed charges,18.85,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.3,20,,,percent of total billed charges,20% of total billed charges,14.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.3,20,,,percent of total billed charges,20% of total billed charges,14.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.48,65,,,percent of total billed charges,65% of total billed charges,46.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.3,48.62,
DIGOXIN ORAL EL 0.05 MG/M,3500234,CDM,250,RC,J3490,HCPCS,outpatient,,,14,7,,9.1,65,,,percent of total billed charges,65% of total billed charges,9.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.1,65,,,percent of total billed charges,65% of total billed charges,9.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,53.67,
DIGOXIN TAB [0.125 MG],3500235,CDM,250,RC,J3490,HCPCS,outpatient,,,8.45,4.23,,5.49,65,,,percent of total billed charges,65% of total billed charges,5.75,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.69,20,,,percent of total billed charges,20% of total billed charges,1.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.69,20,,,percent of total billed charges,20% of total billed charges,1.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.49,65,,,percent of total billed charges,65% of total billed charges,5.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.69,53.67,
DIGOXIN TAB [0.25 MG],3500236,CDM,250,RC,J3490,HCPCS,outpatient,,,8.45,4.23,,5.49,65,,,percent of total billed charges,65% of total billed charges,5.75,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.69,20,,,percent of total billed charges,20% of total billed charges,1.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.69,20,,,percent of total billed charges,20% of total billed charges,1.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.49,65,,,percent of total billed charges,65% of total billed charges,5.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.69,53.67,
DILTIAZEM 5MG/ML-25ML SDV,3521930,CDM,636,RC,J3490,HCPCS,outpatient,,,61.45,30.73,,,,,,other,Not reimbursable per contract ,41.79,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.29,20,,,percent of total billed charges,20% of total billed charges,12.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.29,20,,,percent of total billed charges,20% of total billed charges,12.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.16,80,,,case rate,80% for high cost drug carve out,52.23,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.29,52.23,
DILTIAZEM CD CAP [120 MG],3500238,CDM,250,RC,J3490,HCPCS,outpatient,,,6,3,,3.9,65,,,percent of total billed charges,65% of total billed charges,4.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.2,20,,,percent of total billed charges,20% of total billed charges,1.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.2,20,,,percent of total billed charges,20% of total billed charges,1.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.9,65,,,percent of total billed charges,65% of total billed charges,3.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.2,53.67,
DILTIAZEM CD CAP [180 MG],3500239,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DILTIAZEM CD CAP [240 MG],3500240,CDM,250,RC,J3490,HCPCS,outpatient,,,10.3,5.15,,6.7,65,,,percent of total billed charges,65% of total billed charges,7,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.06,20,,,percent of total billed charges,20% of total billed charges,2.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.06,20,,,percent of total billed charges,20% of total billed charges,2.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.7,65,,,percent of total billed charges,65% of total billed charges,6.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.06,53.67,
DILTIAZEM CD CAP [300  MG,3500237,CDM,250,RC,J3490,HCPCS,outpatient,,,22.95,11.48,,14.92,65,,,percent of total billed charges,65% of total billed charges,15.61,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.59,20,,,percent of total billed charges,20% of total billed charges,4.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.59,20,,,percent of total billed charges,20% of total billed charges,4.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.92,65,,,percent of total billed charges,65% of total billed charges,14.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,53.67,
DILTIAZEM HCL [50 MG/10 M,3500241,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
DILTIAZEM INJ [25 MG/5 ML,3500242,CDM,636,RC,J3490,HCPCS,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,10.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.8,80,,,case rate,80% for high cost drug carve out,13.6,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.2,13.6,
DILTIAZEM TAB [30 MG],3500243,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DILTIAZEM TAB [90 MG],3500244,CDM,250,RC,J3490,HCPCS,outpatient,,,10.75,5.38,,6.99,65,,,percent of total billed charges,65% of total billed charges,7.31,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,20,,,percent of total billed charges,20% of total billed charges,2.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,20,,,percent of total billed charges,20% of total billed charges,2.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.99,65,,,percent of total billed charges,65% of total billed charges,6.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.15,53.67,
DIPHENHYDRAMINE CAP [25 M,3500246,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
DIPHENHYDRAMINE CAP [50 M,3500247,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DIPHENHYDRAMINE INJ [50 M,3500248,CDM,636,RC,J1200,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
DIPHENHYDRAMINE LIQ [12.5,3500249,CDM,250,RC,J1200,HCPCS,outpatient,,,17.9,8.95,,11.64,65,,,percent of total billed charges,65% of total billed charges,12.17,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.58,20,,,percent of total billed charges,20% of total billed charges,3.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.58,20,,,percent of total billed charges,20% of total billed charges,3.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.64,65,,,percent of total billed charges,65% of total billed charges,11.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.58,53.67,
DIPHENOXY/ ATR TAB,3500250,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
DIPRIVAN BRAND INJ [200 M,3500881,CDM,636,RC,J3490,HCPCS,outpatient,,,31.55,15.78,,,,,,other,Not reimbursable per contract ,21.45,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.31,20,,,percent of total billed charges,20% of total billed charges,6.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.31,20,,,percent of total billed charges,20% of total billed charges,6.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.24,80,,,case rate,80% for high cost drug carve out,26.82,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.31,26.82,
DIRECT REFER HOSP OBSERV,3040012,CDM,762,RC,G0379,HCPCS,outpatient,,,435,217.5,,282.75,65,,,percent of total billed charges,65% of total billed charges,295.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,20,,,percent of total billed charges,20% of total billed charges,87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,20,,,percent of total billed charges,20% of total billed charges,87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,282.75,65,,,percent of total billed charges,65% of total billed charges,282.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,980,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,980,
DISARTICULATION KNEE,3462065,CDM,982,RC,27598,HCPCS,outpatient,,,1004,502,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,499.64,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,800.92,110,,,fee schedule,110% of Medicare physician fee schedule,800.92,110,,,fee schedule,110% of Medicare physician fee schedule,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,837.33,115,,,fee schedule,115% of Medicare physician fee schedule,552.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,921.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,499.64,921.06,
DISLOC ELBOW WO ANES,3231045,CDM,450,RC,24600,HCPCS,outpatient,,,545,272.5,,354.25,65,,,percent of total billed charges,65% of total billed charges,370.6,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109,20,,,percent of total billed charges,20% of total billed charges,109,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109,20,,,percent of total billed charges,20% of total billed charges,109,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,354.25,65,,,percent of total billed charges,65% of total billed charges,354.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,327,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,370.6,
DISLOC FINGER CL TX,3231137,CDM,450,RC,26770,HCPCS,outpatient,,,290,145,,188.5,65,,,percent of total billed charges,65% of total billed charges,197.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58,20,,,percent of total billed charges,20% of total billed charges,58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58,20,,,percent of total billed charges,20% of total billed charges,58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,188.5,65,,,percent of total billed charges,65% of total billed charges,188.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,197.2,
DISLOC KNEE W/MA,3231050,CDM,450,RC,27550,HCPCS,outpatient,,,525,262.5,,341.25,65,,,percent of total billed charges,65% of total billed charges,357,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,20,,,percent of total billed charges,20% of total billed charges,105,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,20,,,percent of total billed charges,20% of total billed charges,105,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,341.25,65,,,percent of total billed charges,65% of total billed charges,341.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,357,
DISLOC SHDLR W/MA,3231043,CDM,450,RC,23650,HCPCS,outpatient,,,525,262.5,,341.25,65,,,percent of total billed charges,65% of total billed charges,357,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,20,,,percent of total billed charges,20% of total billed charges,105,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,20,,,percent of total billed charges,20% of total billed charges,105,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,341.25,65,,,percent of total billed charges,65% of total billed charges,341.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,315,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,357,
DISLOC TOE CL TX,3231139,CDM,450,RC,28660,HCPCS,outpatient,,,160,80,,104,65,,,percent of total billed charges,65% of total billed charges,108.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104,65,,,percent of total billed charges,65% of total billed charges,104,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32,178,
DIVALPROEX DR TAB [250 MG,3501059,CDM,250,RC,J3490,HCPCS,outpatient,,,5.4,2.7,,3.51,65,,,percent of total billed charges,65% of total billed charges,3.67,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.08,20,,,percent of total billed charges,20% of total billed charges,1.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.08,20,,,percent of total billed charges,20% of total billed charges,1.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.51,65,,,percent of total billed charges,65% of total billed charges,3.51,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.08,53.67,
DIVALPROEX SPRINKLE  CAP,3500253,CDM,250,RC,J3490,HCPCS,outpatient,,,5.6,2.8,,3.64,65,,,percent of total billed charges,65% of total billed charges,3.81,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.12,20,,,percent of total billed charges,20% of total billed charges,1.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.12,20,,,percent of total billed charges,20% of total billed charges,1.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.64,65,,,percent of total billed charges,65% of total billed charges,3.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,53.67,
DIVALPROEX TAB [500 MG] ER TAB,3501092,CDM,250,RC,,,outpatient,,,12.4,6.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.48,20,,,percent of total billed charges,20% of total billed charges,2.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.48,20,,,percent of total billed charges,20% of total billed charges,2.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.06,65,,,percent of total billed charges,65% of total billed charges,8.06,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.48,53.67,
DIVALPROEX TAB [500 MG] ER TAB,3501092,CDM,250,RC,,,outpatient,,,20.4,10.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,20,,,percent of total billed charges,20% of total billed charges,4.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,20,,,percent of total billed charges,20% of total billed charges,4.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.26,65,,,percent of total billed charges,65% of total billed charges,13.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,53.67,
DNA (DS) ANTIBODY,3300933,CDM,300,RC,86225,HCPCS,outpatient,,,55,27.5,,35.75,65,,,percent of total billed charges,65% of total billed charges,37.4,68,,,percent of total billed charges,68% of total billed charges,19.5,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.75,65,,,percent of total billed charges,65% of total billed charges,35.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11,37.4,
DNA COLLECTION FEE,3300003,CDM,300,RC,36415,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,3,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,17,
DNA DOUBLE STRANDED,3300513,CDM,302,RC,86225,HCPCS,outpatient,,,89,44.5,,57.85,65,,,percent of total billed charges,65% of total billed charges,60.52,68,,,percent of total billed charges,68% of total billed charges,19.5,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.8,20,,,percent of total billed charges,20% of total billed charges,17.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.8,20,,,percent of total billed charges,20% of total billed charges,17.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.85,65,,,percent of total billed charges,65% of total billed charges,57.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.8,60.52,
DOBUTAMINE PREMIX  [12.5,3500256,CDM,636,RC,J1250,HCPCS,outpatient,,,44.3,22.15,,,,,,other,Not reimbursable per contract ,30.12,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.86,20,,,percent of total billed charges,20% of total billed charges,8.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.86,20,,,percent of total billed charges,20% of total billed charges,8.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.44,80,,,case rate,80% for high cost drug carve out,37.66,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.86,37.66,
DOCUSATE CAP [100 MG],3500257,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
DOCUSATE LIQ [100MG /10 M,3500258,CDM,250,RC,J3490,HCPCS,outpatient,,,3.75,1.88,,2.44,65,,,percent of total billed charges,65% of total billed charges,2.55,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.75,20,,,percent of total billed charges,20% of total billed charges,0.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.75,20,,,percent of total billed charges,20% of total billed charges,0.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.44,65,,,percent of total billed charges,65% of total billed charges,2.44,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.75,53.67,
DOK PLUS TAB [8.6-50MG],3501063,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
DONEPEZIL TAB [10 MG],3500259,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DONEPEZIL TAB [5 MG],3500261,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DOPAMINE/D5W 400MG/250ML,3501147,CDM,636,RC,J1265,HCPCS,outpatient,,,65.8,32.9,,,,,,other,Not reimbursable per contract ,44.74,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.16,20,,,percent of total billed charges,20% of total billed charges,13.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.16,20,,,percent of total billed charges,20% of total billed charges,13.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.64,80,,,case rate,80% for high cost drug carve out,55.93,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.16,55.93,
DORZOLAMIDE 2% DRP,3500262,CDM,250,RC,J3490,HCPCS,outpatient,,,133.6,66.8,,86.84,65,,,percent of total billed charges,65% of total billed charges,90.85,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.72,20,,,percent of total billed charges,20% of total billed charges,26.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.72,20,,,percent of total billed charges,20% of total billed charges,26.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.84,65,,,percent of total billed charges,65% of total billed charges,86.84,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,80.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.72,90.85,
DOXAZOSIN TAB [1 MG],3500264,CDM,250,RC,J3490,HCPCS,outpatient,,,6.75,3.38,,4.39,65,,,percent of total billed charges,65% of total billed charges,4.59,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.35,20,,,percent of total billed charges,20% of total billed charges,1.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.35,20,,,percent of total billed charges,20% of total billed charges,1.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.39,65,,,percent of total billed charges,65% of total billed charges,4.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,53.67,
DOXAZOSIN TAB [2 MG],3500265,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
DOXAZOSIN TAB [4 MG],3500266,CDM,250,RC,J3490,HCPCS,outpatient,,,7.1,3.55,,4.62,65,,,percent of total billed charges,65% of total billed charges,4.83,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.42,20,,,percent of total billed charges,20% of total billed charges,1.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.42,20,,,percent of total billed charges,20% of total billed charges,1.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.62,65,,,percent of total billed charges,65% of total billed charges,4.62,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.42,53.67,
DOXCYCLINE 100 MG IV,3521917,CDM,250,RC,,,outpatient,,,82.75,41.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.55,20,,,percent of total billed charges,20% of total billed charges,16.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.55,20,,,percent of total billed charges,20% of total billed charges,16.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.79,65,,,percent of total billed charges,65% of total billed charges,53.79,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.55,53.79,
DOXEPIN,3300215,CDM,301,RC,80166,HCPCS,outpatient,,,100,50,,65,65,,,percent of total billed charges,65% of total billed charges,68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,65,,,percent of total billed charges,65% of total billed charges,65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20,68,
DOXYCYCLINE CAP [100 MG],3500268,CDM,250,RC,J3490,HCPCS,outpatient,,,12.3,6.15,,8,65,,,percent of total billed charges,65% of total billed charges,8.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.46,20,,,percent of total billed charges,20% of total billed charges,2.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.46,20,,,percent of total billed charges,20% of total billed charges,2.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,65,,,percent of total billed charges,65% of total billed charges,8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.46,53.67,
DOXYCYCLINE INJ [100 MG],3500269,CDM,636,RC,J3490,HCPCS,outpatient,,,142.2,71.1,,,,,,other,Not reimbursable per contract ,96.7,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.44,20,,,percent of total billed charges,20% of total billed charges,28.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.44,20,,,percent of total billed charges,20% of total billed charges,28.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.76,80,,,case rate,80% for high cost drug carve out,120.87,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.44,120.87,
DRAIN/FINGER ABCESS,3230913,CDM,450,RC,26010,HCPCS,outpatient,,,207,103.5,,134.55,65,,,percent of total billed charges,65% of total billed charges,140.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,20,,,percent of total billed charges,20% of total billed charges,41.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,20,,,percent of total billed charges,20% of total billed charges,41.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,134.55,65,,,percent of total billed charges,65% of total billed charges,134.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,178,
DRAIN/INJ JOINT/BURSA W/O US,3700319,CDM,510,RC,20605,HCPCS,outpatient,,,139,69.5,,90.35,65,,,percent of total billed charges,65% of total billed charges,94.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.35,65,,,percent of total billed charges,65% of total billed charges,90.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.8,178,
DRAIN/INJ JOINT/BURSA W/O US,3700320,CDM,983,RC,20605,HCPCS,outpatient,,,98,49,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.15,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.97,110,,,fee schedule,110% of Medicare physician fee schedule,41.97,110,,,fee schedule,110% of Medicare physician fee schedule,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.87,115,,,fee schedule,115% of Medicare physician fee schedule,77.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.15,77.75,
DRAINAGE OF SKIN ABSCESS SIMP/SINGLE,3700288,CDM,510,RC,10060,HCPCS,outpatient,,,362,181,,235.3,65,,,percent of total billed charges,65% of total billed charges,246.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.4,20,,,percent of total billed charges,20% of total billed charges,72.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.4,20,,,percent of total billed charges,20% of total billed charges,72.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,235.3,65,,,percent of total billed charges,65% of total billed charges,235.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,217.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,246.16,
"DRAPE, STERILE SMALL",6210264,CDM,272,RC,,,outpatient,,,13.45,6.73,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.69,20,,,percent of total billed charges,20% of total billed charges,2.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.69,20,,,percent of total billed charges,20% of total billed charges,2.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.74,65,,,percent of total billed charges,65% of total billed charges,8.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,53.67,
DRAW BLOOD,3300001,CDM,300,RC,36415,HCPCS,outpatient,,,15,7.5,,9.75,65,,,percent of total billed charges,65% of total billed charges,10.2,68,,,percent of total billed charges,68% of total billed charges,3,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,10.2,
DRESSING HYDROGEL AMORPHOUS 1oz,3250062,CDM,272,RC,,,outpatient,,,20.1,10.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.02,20,,,percent of total billed charges,20% of total billed charges,4.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.02,20,,,percent of total billed charges,20% of total billed charges,4.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.07,65,,,percent of total billed charges,65% of total billed charges,13.07,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.02,53.67,
DRESSING WET STR 8X4,3250403,CDM,272,RC,,,outpatient,,,11.9,5.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.38,20,,,percent of total billed charges,20% of total billed charges,2.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.38,20,,,percent of total billed charges,20% of total billed charges,2.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.74,65,,,percent of total billed charges,65% of total billed charges,7.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.38,53.67,
DRUG SCREEN CONFIRM,3300275,CDM,301,RC,80305,HCPCS,outpatient,,,62,31,,40.3,65,,,percent of total billed charges,65% of total billed charges,42.16,68,,,percent of total billed charges,68% of total billed charges,19.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.3,65,,,percent of total billed charges,65% of total billed charges,40.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.4,42.16,
DRUG SCREEN MULTI DRUG,3300869,CDM,301,RC,80305,HCPCS,outpatient,,,21,10.5,,13.65,65,,,percent of total billed charges,65% of total billed charges,14.28,68,,,percent of total billed charges,68% of total billed charges,19.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.65,65,,,percent of total billed charges,65% of total billed charges,13.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,19.58,
DRUG SCREEN PANEL CH,3300395,CDM,301,RC,80305,HCPCS,outpatient,,,,,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract ,19.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,,,,,other,Not reimbursable,19.58,19.58,
DRUGS ABUSE II (UA),3300079,CDM,301,RC,80102,HCPCS,outpatient,,,96,48,,62.4,65,,,percent of total billed charges,65% of total billed charges,65.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.4,65,,,percent of total billed charges,65% of total billed charges,62.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,65.28,
DUAL CANNULA 02/CO2 14FT,6215874,CDM,272,RC,,,outpatient,,,42.9,21.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.58,20,,,percent of total billed charges,20% of total billed charges,8.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.58,20,,,percent of total billed charges,20% of total billed charges,8.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.89,65,,,percent of total billed charges,65% of total billed charges,27.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,53.67,
DULOXETINE CAP [30 MG],3500271,CDM,250,RC,J3490,HCPCS,outpatient,,,39.3,19.65,,25.55,65,,,percent of total billed charges,65% of total billed charges,26.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.86,20,,,percent of total billed charges,20% of total billed charges,7.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.86,20,,,percent of total billed charges,20% of total billed charges,7.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.55,65,,,percent of total billed charges,65% of total billed charges,25.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,53.67,
DULOXETINE CAP [60 MG],3500272,CDM,250,RC,J3490,HCPCS,outpatient,,,39.3,19.65,,25.55,65,,,percent of total billed charges,65% of total billed charges,26.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.86,20,,,percent of total billed charges,20% of total billed charges,7.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.86,20,,,percent of total billed charges,20% of total billed charges,7.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.55,65,,,percent of total billed charges,65% of total billed charges,25.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,53.67,
DUO-DERM 3X3 EXTRA THIN,3250646,CDM,272,RC,,,outpatient,,,25.6,12.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.12,20,,,percent of total billed charges,20% of total billed charges,5.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.12,20,,,percent of total billed charges,20% of total billed charges,5.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.64,65,,,percent of total billed charges,65% of total billed charges,16.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.12,53.67,
DUO-DERM 4X4 EXTRA THIN,3250642,CDM,272,RC,,,outpatient,,,28.2,14.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.64,20,,,percent of total billed charges,20% of total billed charges,5.64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.64,20,,,percent of total billed charges,20% of total billed charges,5.64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.33,65,,,percent of total billed charges,65% of total billed charges,18.33,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,53.67,
DUO-DERM 4X4 THICK,3250645,CDM,272,RC,,,outpatient,,,57,28.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,53.67,
DUP FILMS/CD FOR PATIENT,3400129,CDM,999,RC,76499,HCPCS,outpatient,,,7,3.5,,4.55,65,,,percent of total billed charges,65% of total billed charges,4.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.4,20,,,percent of total billed charges,20% of total billed charges,1.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.4,20,,,percent of total billed charges,20% of total billed charges,1.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.55,65,,,percent of total billed charges,65% of total billed charges,4.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,4.76,
DUTASTERIDE CAP [0.5 MG],3500273,CDM,250,RC,J3490,HCPCS,outpatient,,,30.25,15.13,,19.66,65,,,percent of total billed charges,65% of total billed charges,20.57,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.05,20,,,percent of total billed charges,20% of total billed charges,6.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.05,20,,,percent of total billed charges,20% of total billed charges,6.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.66,65,,,percent of total billed charges,65% of total billed charges,19.66,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.05,53.67,
DVT SLEEVE LG,6215793,CDM,272,RC,,,outpatient,,,178.04,89.02,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.61,20,,,percent of total billed charges,20% of total billed charges,35.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.61,20,,,percent of total billed charges,20% of total billed charges,35.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.73,65,,,percent of total billed charges,65% of total billed charges,115.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.61,115.73,
DVT SLEEVE MD,6215792,CDM,272,RC,,,outpatient,,,124.69,62.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.94,20,,,percent of total billed charges,20% of total billed charges,24.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.94,20,,,percent of total billed charges,20% of total billed charges,24.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.05,65,,,percent of total billed charges,65% of total billed charges,81.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.94,81.05,
DVT SLEEVE SM,6215791,CDM,272,RC,,,outpatient,,,186.73,93.37,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.35,20,,,percent of total billed charges,20% of total billed charges,37.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.35,20,,,percent of total billed charges,20% of total billed charges,37.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,121.37,65,,,percent of total billed charges,65% of total billed charges,121.37,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.35,121.37,
EAR IRRIGATION,3231164,CDM,450,RC,69209,HCPCS,outpatient,,,46.5,23.25,,30.23,65,,,percent of total billed charges,65% of total billed charges,31.62,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,20,,,percent of total billed charges,20% of total billed charges,9.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,20,,,percent of total billed charges,20% of total billed charges,9.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.23,65,,,percent of total billed charges,65% of total billed charges,30.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,178,
EBV AB 1GM VCA,3300505,CDM,302,RC,86665,HCPCS,outpatient,,,180,90,,117,65,,,percent of total billed charges,65% of total billed charges,122.4,68,,,percent of total billed charges,68% of total billed charges,25.75,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,20,,,percent of total billed charges,20% of total billed charges,36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,20,,,percent of total billed charges,20% of total billed charges,36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,65,,,percent of total billed charges,65% of total billed charges,117,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.75,122.4,
EBV IGG VCA,3300615,CDM,302,RC,86665,HCPCS,outpatient,,,161,80.5,,104.65,65,,,percent of total billed charges,65% of total billed charges,109.48,68,,,percent of total billed charges,68% of total billed charges,25.75,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.2,20,,,percent of total billed charges,20% of total billed charges,32.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.2,20,,,percent of total billed charges,20% of total billed charges,32.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104.65,65,,,percent of total billed charges,65% of total billed charges,104.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.75,109.48,
ED VISIT HIGH SEVERITY THREAT FUNCJ,3462101,CDM,982,RC,99285,HCPCS,outpatient,,,238,119,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,122.23,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,197.68,109,,,fee schedule,109% of Medicare physician fee schedule,397.18,109,,,fee schedule,109% of Medicare physician fee schedule,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,667.56,115,,,fee schedule,115% of Medicare physician fee schedule,170.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.23,667.56,
ED VISIT HIGH/URGENT SEVERITY,3462100,CDM,982,RC,99284,HCPCS,outpatient,,,164,82,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,84.15,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.47,109,,,fee schedule,109% of Medicare physician fee schedule,272.17,109,,,fee schedule,109% of Medicare physician fee schedule,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,601.92,115,,,fee schedule,115% of Medicare physician fee schedule,132.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.15,601.92,
ED VISIT LIMITED/MINOR PROB,3462097,CDM,982,RC,99281,HCPCS,outpatient,,,34,17,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.36,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,13.45,109,,,fee schedule,109% of Medicare physician fee schedule,27.02,109,,,fee schedule,109% of Medicare physician fee schedule,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,473.19,115,,,fee schedule,115% of Medicare physician fee schedule,63.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.45,473.19,
ED VISIT LOW/MODER SEVERITY,3462098,CDM,982,RC,99282,HCPCS,outpatient,,,65,32.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.76,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,47,109,,,fee schedule,109% of Medicare physician fee schedule,94.43,109,,,fee schedule,109% of Medicare physician fee schedule,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,508.59,115,,,fee schedule,115% of Medicare physician fee schedule,78.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.76,508.59,
ED VISIT MODERATE SEVERITY,3462099,CDM,982,RC,99283,HCPCS,outpatient,,,97,48.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,45.8,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.89,109,,,fee schedule,109% of Medicare physician fee schedule,162.52,109,,,fee schedule,109% of Medicare physician fee schedule,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,544.34,115,,,fee schedule,115% of Medicare physician fee schedule,94.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.8,544.34,
EGD,3060227,CDM,750,RC,43235,HCPCS,outpatient,,,1221,610.5,,793.65,65,,,percent of total billed charges,65% of total billed charges,830.28,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,244.2,20,,,percent of total billed charges,20% of total billed charges,244.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,244.2,20,,,percent of total billed charges,20% of total billed charges,244.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,793.65,65,,,percent of total billed charges,65% of total billed charges,793.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,830.28,
EGD DISCONTINUED,3060228,CDM,750,RC,43235,HCPCS,outpatient,,,700,350,,455,65,,,percent of total billed charges,65% of total billed charges,476,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140,20,,,percent of total billed charges,20% of total billed charges,140,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140,20,,,percent of total billed charges,20% of total billed charges,140,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,455,65,,,percent of total billed charges,65% of total billed charges,455,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,420,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,665,
EGD FLEXIBLE FB REMOVED,3462077,CDM,982,RC,43247,HCPCS,outpatient,,,490,245,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,119.53,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,196.43,110,,,fee schedule,110% of Medicare physician fee schedule,196.43,110,,,fee schedule,110% of Medicare physician fee schedule,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,205.36,115,,,fee schedule,115% of Medicare physician fee schedule,172.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.89,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,119.53,225.89,
EGD PLACE G-TUBE,3462010,CDM,982,RC,43246,HCPCS,outpatient,,,1380,690,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,140.87,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,224.62,110,,,fee schedule,110% of Medicare physician fee schedule,224.62,110,,,fee schedule,110% of Medicare physician fee schedule,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,234.83,115,,,fee schedule,115% of Medicare physician fee schedule,193.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,140.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,258.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,140.87,258.31,
EGD PLACE GTUBE,3060414,CDM,360,RC,43246,HCPCS,outpatient,,,1054,527,,685.1,65,,,percent of total billed charges,65% of total billed charges,716.72,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210.8,20,,,percent of total billed charges,20% of total billed charges,210.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210.8,20,,,percent of total billed charges,20% of total billed charges,210.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,685.1,65,,,percent of total billed charges,65% of total billed charges,685.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,632.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,716.72,
EGD W/BIOPSY-PROFEE,3462000,CDM,982,RC,43239,HCPCS,outpatient,,,1380,690,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,153.12,110,,,fee schedule,110% of Medicare physician fee schedule,153.12,110,,,fee schedule,110% of Medicare physician fee schedule,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,160.08,115,,,fee schedule,115% of Medicare physician fee schedule,145.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.22,176.09,
EGD W/O BIOPSY-PROF FEE,3462001,CDM,982,RC,43235,HCPCS,outpatient,,,1370,685,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.84,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.76,110,,,fee schedule,110% of Medicare physician fee schedule,135.76,110,,,fee schedule,110% of Medicare physician fee schedule,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.93,115,,,fee schedule,115% of Medicare physician fee schedule,135.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,156.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.84,156.13,
EGD WITH  BIOPSY,3060229,CDM,750,RC,43239,HCPCS,outpatient,,,1221,610.5,,793.65,65,,,percent of total billed charges,65% of total billed charges,830.28,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,244.2,20,,,percent of total billed charges,20% of total billed charges,244.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,244.2,20,,,percent of total billed charges,20% of total billed charges,244.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,793.65,65,,,percent of total billed charges,65% of total billed charges,793.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,830.28,
EGD WITH POLYPECTOMY,3060273,CDM,750,RC,43239,HCPCS,outpatient,,,1221,610.5,,793.65,65,,,percent of total billed charges,65% of total billed charges,830.28,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,244.2,20,,,percent of total billed charges,20% of total billed charges,244.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,244.2,20,,,percent of total billed charges,20% of total billed charges,244.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,793.65,65,,,percent of total billed charges,65% of total billed charges,793.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,732.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,830.28,
EGGCRATE MATTRESS,3250143,CDM,271,RC,,,outpatient,,,42.7,21.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.54,20,,,percent of total billed charges,20% of total billed charges,8.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.54,20,,,percent of total billed charges,20% of total billed charges,8.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.76,65,,,percent of total billed charges,65% of total billed charges,27.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.54,53.67,
EKG ROUTINE W/ELECT,3180001,CDM,730,RC,93005,HCPCS,outpatient,,,347,173.5,,225.55,65,,,percent of total billed charges,65% of total billed charges,235.96,68,,,percent of total billed charges,68% of total billed charges,36.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.4,20,,,percent of total billed charges,20% of total billed charges,69.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.4,20,,,percent of total billed charges,20% of total billed charges,69.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,225.55,65,,,percent of total billed charges,65% of total billed charges,225.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,208.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.14,235.96,
ELBOW 2/VIEWS LT LTD,3440051,CDM,972,RC,73070,HCPCS,outpatient,,,44,22,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.41,115,,,fee schedule,115% of Medicare physician fee schedule,67.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.95,209.41,
ELBOW 2/VIEWS RT LTD,3440055,CDM,972,RC,73070,HCPCS,outpatient,,,44,22,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.41,115,,,fee schedule,115% of Medicare physician fee schedule,67.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.95,209.41,
ELBOW BIL 2 VIEW,3400117,CDM,320,RC,73070,HCPCS,outpatient,,,158,79,,102.7,65,,,percent of total billed charges,65% of total billed charges,107.44,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.6,20,,,percent of total billed charges,20% of total billed charges,31.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.6,20,,,percent of total billed charges,20% of total billed charges,31.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.7,65,,,percent of total billed charges,65% of total billed charges,102.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
ELBOW BIL 2 VIEW,3440401,CDM,972,RC,73070,HCPCS,outpatient,,,86.9,43.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.41,115,,,fee schedule,115% of Medicare physician fee schedule,67.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.95,209.41,
ELBOW BIL COMPLETE,3440047,CDM,972,RC,73080,HCPCS,outpatient,,,145,72.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,110,,,fee schedule,110% of Medicare physician fee schedule,35.09,110,,,fee schedule,110% of Medicare physician fee schedule,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.09,115,,,fee schedule,115% of Medicare physician fee schedule,69.67,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.07,213.09,
ELBOW LT COMPLETE,3440049,CDM,972,RC,73080,HCPCS,outpatient,,,86.9,43.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,110,,,fee schedule,110% of Medicare physician fee schedule,35.09,110,,,fee schedule,110% of Medicare physician fee schedule,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.09,115,,,fee schedule,115% of Medicare physician fee schedule,69.67,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.07,213.09,
ELBOW RT COMPLETE,3440053,CDM,972,RC,73080,HCPCS,outpatient,,,86.9,43.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,110,,,fee schedule,110% of Medicare physician fee schedule,35.09,110,,,fee schedule,110% of Medicare physician fee schedule,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.09,115,,,fee schedule,115% of Medicare physician fee schedule,69.67,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.07,213.09,
ELBOW-BIL COMPLETE,3400070,CDM,320,RC,73080,HCPCS,outpatient,,,178,89,,115.7,65,,,percent of total billed charges,65% of total billed charges,121.04,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.6,20,,,percent of total billed charges,20% of total billed charges,35.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.6,20,,,percent of total billed charges,20% of total billed charges,35.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.7,65,,,percent of total billed charges,65% of total billed charges,115.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
ELBOW-L 2 VIEWS,3400063,CDM,320,RC,73070,HCPCS,outpatient,,,126.5,63.25,,82.23,65,,,percent of total billed charges,65% of total billed charges,86.02,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.23,65,,,percent of total billed charges,65% of total billed charges,82.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
ELBOW-L COMPLETE,3400017,CDM,320,RC,73080,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
ELBOW-R 2 VIEWS,3400071,CDM,320,RC,73070,HCPCS,outpatient,,,126.5,63.25,,82.23,65,,,percent of total billed charges,65% of total billed charges,86.02,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.23,65,,,percent of total billed charges,65% of total billed charges,82.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
ELBOW-R COMPLETE,3400069,CDM,320,RC,73080,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
ELECTRIC STIMULATION,3600013,CDM,420,RC,G0283,HCPCS,outpatient,,,97,48.5,,63.05,65,,,percent of total billed charges,65% of total billed charges,65.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.05,65,,,percent of total billed charges,65% of total billed charges,63.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.4,82,
"ELECTRODE NEEDLE 6""",6210287,CDM,272,RC,,,outpatient,,,26.9,13.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.38,20,,,percent of total billed charges,20% of total billed charges,5.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.38,20,,,percent of total billed charges,20% of total billed charges,5.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.49,65,,,percent of total billed charges,65% of total billed charges,17.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,53.67,
ELECTRODES TRIPLE,3060117,CDM,272,RC,,,outpatient,,,59.4,29.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.88,20,,,percent of total billed charges,20% of total billed charges,11.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.88,20,,,percent of total billed charges,20% of total billed charges,11.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.61,65,,,percent of total billed charges,65% of total billed charges,38.61,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.88,53.67,
ELECTROLYTES,3300049,CDM,301,RC,80051,HCPCS,outpatient,,,46.2,23.1,,30.03,65,,,percent of total billed charges,65% of total billed charges,31.42,68,,,percent of total billed charges,68% of total billed charges,9.69,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,20,,,percent of total billed charges,20% of total billed charges,9.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,20,,,percent of total billed charges,20% of total billed charges,9.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.03,65,,,percent of total billed charges,65% of total billed charges,30.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.1,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,31.42,
ELECTROPHORESIS IMMU,3300267,CDM,302,RC,86334,HCPCS,outpatient,,,42,21,,27.3,65,,,percent of total billed charges,65% of total billed charges,28.56,68,,,percent of total billed charges,68% of total billed charges,31.71,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,20,,,percent of total billed charges,20% of total billed charges,8.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,20,,,percent of total billed charges,20% of total billed charges,8.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.3,65,,,percent of total billed charges,65% of total billed charges,27.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,31.71,
EMER CARE LEVEL 1,3230969,CDM,450,RC,99281,HCPCS,outpatient,,,96,48,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.4,65,,,percent of total billed charges,65% of total billed charges,62.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,735,
EMER CARE LEVEL 2,3230973,CDM,450,RC,99282,HCPCS,outpatient,,,123,61.5,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,20,,,percent of total billed charges,20% of total billed charges,24.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,20,,,percent of total billed charges,20% of total billed charges,24.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.95,65,,,percent of total billed charges,65% of total billed charges,79.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,735,
EMER CARE LEVEL 3,3230977,CDM,450,RC,99283,HCPCS,outpatient,,,185,92.5,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,20,,,percent of total billed charges,20% of total billed charges,37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,20,,,percent of total billed charges,20% of total billed charges,37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.25,65,,,percent of total billed charges,65% of total billed charges,120.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37,735,
EMER CARE LEVEL 4,3230981,CDM,450,RC,99284,HCPCS,outpatient,,,296,148,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.2,20,,,percent of total billed charges,20% of total billed charges,59.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.2,20,,,percent of total billed charges,20% of total billed charges,59.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192.4,65,,,percent of total billed charges,65% of total billed charges,192.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,735,
EMER CARE LEVEL 5,3230985,CDM,450,RC,99285,HCPCS,outpatient,,,440,220,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88,20,,,percent of total billed charges,20% of total billed charges,88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88,20,,,percent of total billed charges,20% of total billed charges,88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,286,65,,,percent of total billed charges,65% of total billed charges,286,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,735,
EMOLLIENT LOT,3500274,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
EMOLLIENT OINT,3500275,CDM,250,RC,J3490,HCPCS,outpatient,,,6.45,3.23,,4.19,65,,,percent of total billed charges,65% of total billed charges,4.39,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.29,20,,,percent of total billed charges,20% of total billed charges,1.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.29,20,,,percent of total billed charges,20% of total billed charges,1.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.19,65,,,percent of total billed charges,65% of total billed charges,4.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.29,53.67,
EMOLLIENT/ SKIN CLEANSER,3500276,CDM,250,RC,J3490,HCPCS,outpatient,,,17.2,8.6,,11.18,65,,,percent of total billed charges,65% of total billed charges,11.7,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.44,20,,,percent of total billed charges,20% of total billed charges,3.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.44,20,,,percent of total billed charges,20% of total billed charges,3.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.18,65,,,percent of total billed charges,65% of total billed charges,11.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,53.67,
EMPY EVACUATED CONT.,3250641,CDM,271,RC,,,outpatient,,,13.5,6.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.7,20,,,percent of total billed charges,20% of total billed charges,2.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.7,20,,,percent of total billed charges,20% of total billed charges,2.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.78,65,,,percent of total billed charges,65% of total billed charges,8.78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.7,53.67,
ENALAPRILAT INJ [1.25 MG/,3500280,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
ENDO LOWER INT-CRNA,3220161,CDM,964,RC,812,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,141,,,,fee schedule,110% of Medicare physician fee schedule,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,125.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.5,141,
ENDO LOWER INT-FAC,3220159,CDM,370,RC,,,outpatient,,,800,400,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,65,,,percent of total billed charges,65% of total billed charges,520,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,520,
ENDO SPOT PER 1 MG,3060169,CDM,636,RC,Q9968,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,80,,,case rate,80% for high cost drug carve out,71.4,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,71.4,
ENDO UPPER GI-CRNA,3220147,CDM,964,RC,731,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,235,,,,fee schedule,110% of Medicare physician fee schedule,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,125.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,220,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.48,235,
ENDO UPPER GI-FAC,3220145,CDM,370,RC,,,outpatient,,,800,400,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160,20,,,percent of total billed charges,20% of total billed charges,160,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520,65,,,percent of total billed charges,65% of total billed charges,520,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,480,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,520,
ENEMA SET ECONOMY,3250501,CDM,272,RC,,,outpatient,,,55.6,27.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.12,20,,,percent of total billed charges,20% of total billed charges,11.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.12,20,,,percent of total billed charges,20% of total billed charges,11.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.14,65,,,percent of total billed charges,65% of total billed charges,36.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.12,53.67,
ENOXAPARIN INJ SYR [100 M,3500281,CDM,636,RC,J1650,HCPCS,outpatient,,,81,40.5,,,,,,other,Not reimbursable per contract ,55.08,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,20,,,percent of total billed charges,20% of total billed charges,16.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,20,,,percent of total billed charges,20% of total billed charges,16.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,80,,,case rate,80% for high cost drug carve out,68.85,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,68.85,
ENOXAPARIN INJ SYR [120 M,3500282,CDM,636,RC,J1650,HCPCS,outpatient,,,97.2,48.6,,,,,,other,Not reimbursable per contract ,66.1,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.44,20,,,percent of total billed charges,20% of total billed charges,19.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.44,20,,,percent of total billed charges,20% of total billed charges,19.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.76,80,,,case rate,80% for high cost drug carve out,82.62,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,82.62,
ENOXAPARIN INJ SYR [30 MG,3500283,CDM,636,RC,J1650,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
ENOXAPARIN INJ SYR [40 MG,3500284,CDM,636,RC,J1650,HCPCS,outpatient,,,32.4,16.2,,,,,,other,Not reimbursable per contract ,22.03,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.48,20,,,percent of total billed charges,20% of total billed charges,6.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.48,20,,,percent of total billed charges,20% of total billed charges,6.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.92,80,,,case rate,80% for high cost drug carve out,27.54,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,27.54,
ENOXAPARIN INJ SYR [60 MG,3500285,CDM,636,RC,J1650,HCPCS,outpatient,,,48.6,24.3,,,,,,other,Not reimbursable per contract ,33.05,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,20,,,percent of total billed charges,20% of total billed charges,9.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,20,,,percent of total billed charges,20% of total billed charges,9.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.88,80,,,case rate,80% for high cost drug carve out,41.31,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,41.31,
ENOXAPARIN INJ SYR [80 MG,3500286,CDM,636,RC,J1650,HCPCS,outpatient,,,64.8,32.4,,,,,,other,Not reimbursable per contract ,44.06,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.96,20,,,percent of total billed charges,20% of total billed charges,12.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.96,20,,,percent of total billed charges,20% of total billed charges,12.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.84,80,,,case rate,80% for high cost drug carve out,55.08,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,55.08,
ENSURE 8 OZ,3250005,CDM,999,RC,,,outpatient,,,10.95,5.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.19,20,,,percent of total billed charges,20% of total billed charges,2.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.19,20,,,percent of total billed charges,20% of total billed charges,2.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.12,65,,,percent of total billed charges,65% of total billed charges,7.12,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.19,7.12,
ENSURE PLUS 8 OZ,3250001,CDM,999,RC,,,outpatient,,,10.95,5.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.19,20,,,percent of total billed charges,20% of total billed charges,2.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.19,20,,,percent of total billed charges,20% of total billed charges,2.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.12,65,,,percent of total billed charges,65% of total billed charges,7.12,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.19,7.12,
ENTERAL NUTRITION CN,3250449,CDM,272,RC,,,outpatient,,,46.85,23.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.37,20,,,percent of total billed charges,20% of total billed charges,9.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.37,20,,,percent of total billed charges,20% of total billed charges,9.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.45,65,,,percent of total billed charges,65% of total billed charges,30.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.37,53.67,
ENTERNAL BAG SET W/FLUSH,3250440,CDM,271,RC,,,outpatient,,,46.07,23.04,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.21,20,,,percent of total billed charges,20% of total billed charges,9.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.21,20,,,percent of total billed charges,20% of total billed charges,9.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.95,65,,,percent of total billed charges,65% of total billed charges,29.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.21,53.67,
ENTIRE SPINE AP & LAT,3400195,CDM,320,RC,72082,HCPCS,outpatient,,,91.12,45.56,,59.23,65,,,percent of total billed charges,65% of total billed charges,61.96,68,,,percent of total billed charges,68% of total billed charges,24.56,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.22,20,,,percent of total billed charges,20% of total billed charges,18.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.22,20,,,percent of total billed charges,20% of total billed charges,18.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.23,65,,,percent of total billed charges,65% of total billed charges,59.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.22,180,
ENTIRE SPINE AP & LAT,3440451,CDM,972,RC,72082,HCPCS,outpatient,,,77,38.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,34.15,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,75.2,110,,,fee schedule,110% of Medicare physician fee schedule,75.2,110,,,fee schedule,110% of Medicare physician fee schedule,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,255.01,115,,,fee schedule,115% of Medicare physician fee schedule,86.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.15,255.01,
ENZY DIGESTION,3300375,CDM,301,RC,,,outpatient,,,50,25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.5,35,,,percent of total billed charges,35% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,32.5,
EPHEDRINE INJ [50 MG/ML],3500287,CDM,636,RC,J3490,HCPCS,outpatient,,,237.5,118.75,,,,,,other,Not reimbursable per contract ,161.5,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.5,20,,,percent of total billed charges,20% of total billed charges,47.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.5,20,,,percent of total billed charges,20% of total billed charges,47.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190,80,,,case rate,80% for high cost drug carve out,201.88,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.5,201.88,
EPIDURAL KIT,6215853,CDM,272,RC,,,outpatient,,,371.25,185.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.25,20,,,percent of total billed charges,20% of total billed charges,74.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.25,20,,,percent of total billed charges,20% of total billed charges,74.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.31,65,,,percent of total billed charges,65% of total billed charges,241.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,241.31,
EPINEPHRINE INJ [1 MG/ML,3500288,CDM,636,RC,J0171,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
EPINEPHRINE INJ [1MG/ML],3500289,CDM,636,RC,J0171,HCPCS,outpatient,,,78.75,39.38,,,,,,other,Not reimbursable per contract ,53.55,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.75,20,,,percent of total billed charges,20% of total billed charges,15.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.75,20,,,percent of total billed charges,20% of total billed charges,15.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63,80,,,case rate,80% for high cost drug carve out,66.94,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.75,66.94,
EPINEPHRINE INJ SYR [1 MG,3500290,CDM,636,RC,J0171,HCPCS,outpatient,,,47.25,23.63,,,,,,other,Not reimbursable per contract ,32.13,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.45,20,,,percent of total billed charges,20% of total billed charges,9.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.45,20,,,percent of total billed charges,20% of total billed charges,9.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,80,,,case rate,80% for high cost drug carve out,40.16,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.45,40.16,
"EPOETIN ALFA INJ [4,000 U",3500292,CDM,636,RC,J0885,HCPCS,outpatient,,,465.05,232.53,,,,,,other,Not reimbursable per contract ,316.23,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.01,20,,,percent of total billed charges,20% of total billed charges,93.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.01,20,,,percent of total billed charges,20% of total billed charges,93.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,372.04,80,,,case rate,80% for high cost drug carve out,395.29,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,279.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.01,395.29,
"EPOETIN ALFA INJ [4,000 U",3500292,CDM,636,RC,J0885,HCPCS,outpatient,,,513.15,256.58,,333.55,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,348.94,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.63,20,,,percent of total billed charges,20% of total billed charges,102.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.63,20,,,percent of total billed charges,20% of total billed charges,102.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,410.52,80,,,case rate,80% for high cost drug carve out,436.18,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,307.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102.63,436.18,
EPSOM SALT GR,3500293,CDM,250,RC,J3490,HCPCS,outpatient,,,18.95,9.48,,12.32,65,,,percent of total billed charges,65% of total billed charges,12.89,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.79,20,,,percent of total billed charges,20% of total billed charges,3.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.79,20,,,percent of total billed charges,20% of total billed charges,3.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.32,65,,,percent of total billed charges,65% of total billed charges,12.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.79,53.67,
EPUMP SPIKE SET,3250617,CDM,272,RC,,,outpatient,,,19.1,9.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.82,20,,,percent of total billed charges,20% of total billed charges,3.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.82,20,,,percent of total billed charges,20% of total billed charges,3.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.42,65,,,percent of total billed charges,65% of total billed charges,12.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.82,53.67,
ER LEVEL 1 WI PROCD,3230971,CDM,450,RC,99281,HCPCS,outpatient,,,96,48,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.4,65,,,percent of total billed charges,65% of total billed charges,62.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,735,
ER LEVEL 2 WI PROCD,3230975,CDM,450,RC,99282,HCPCS,outpatient,,,123,61.5,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,20,,,percent of total billed charges,20% of total billed charges,24.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,20,,,percent of total billed charges,20% of total billed charges,24.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.95,65,,,percent of total billed charges,65% of total billed charges,79.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,735,
ER LEVEL 3 WI PROCD,3230979,CDM,450,RC,99283,HCPCS,outpatient,,,185,92.5,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,20,,,percent of total billed charges,20% of total billed charges,37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37,20,,,percent of total billed charges,20% of total billed charges,37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.25,65,,,percent of total billed charges,65% of total billed charges,120.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37,735,
ER LEVEL 4 WI PROCD,3230983,CDM,450,RC,99284,HCPCS,outpatient,,,296,148,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.2,20,,,percent of total billed charges,20% of total billed charges,59.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.2,20,,,percent of total billed charges,20% of total billed charges,59.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192.4,65,,,percent of total billed charges,65% of total billed charges,192.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,735,
ER LEVEL 5 WI PROCD,3230987,CDM,450,RC,99285,HCPCS,outpatient,,,440,220,,700,100,,,case rate,700 case rate for ER,735,100,,,case rate,735 case rate for ER,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88,20,,,percent of total billed charges,20% of total billed charges,88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88,20,,,percent of total billed charges,20% of total billed charges,88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,286,65,,,percent of total billed charges,65% of total billed charges,286,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,264,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,735,
ER TOX SCREEN,3300789,CDM,301,RC,80307,HCPCS,outpatient,,,148,74,,96.2,65,,,percent of total billed charges,65% of total billed charges,100.64,68,,,percent of total billed charges,68% of total billed charges,19.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.6,20,,,percent of total billed charges,20% of total billed charges,29.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.6,20,,,percent of total billed charges,20% of total billed charges,29.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.2,65,,,percent of total billed charges,65% of total billed charges,96.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.58,100.64,
ERTAPENEM [1 GM],3500975,CDM,636,RC,J1335,HCPCS,outpatient,,,561.95,280.98,,365.27,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,382.13,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.39,20,,,percent of total billed charges,20% of total billed charges,112.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.39,20,,,percent of total billed charges,20% of total billed charges,112.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,449.56,80,,,case rate,80% for high cost drug carve out,477.66,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,337.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,112.39,477.66,
ERYTHROMYCIN [5 MG/GM] 3.,3500297,CDM,250,RC,,,outpatient,,,24.85,12.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.97,20,,,percent of total billed charges,20% of total billed charges,4.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.97,20,,,percent of total billed charges,20% of total billed charges,4.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.15,65,,,percent of total billed charges,65% of total billed charges,16.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.97,53.67,
ERYTHROMYCIN TAB [250 MG],3500299,CDM,250,RC,J3490,HCPCS,outpatient,,,33.6,16.8,,21.84,65,,,percent of total billed charges,65% of total billed charges,22.85,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.72,20,,,percent of total billed charges,20% of total billed charges,6.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.72,20,,,percent of total billed charges,20% of total billed charges,6.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.84,65,,,percent of total billed charges,65% of total billed charges,21.84,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.72,53.67,
ERYTHROPOIETIN,3300299,CDM,301,RC,82668,HCPCS,outpatient,,,137,68.5,,89.05,65,,,percent of total billed charges,65% of total billed charges,93.16,68,,,percent of total billed charges,68% of total billed charges,26.68,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.4,20,,,percent of total billed charges,20% of total billed charges,27.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.4,20,,,percent of total billed charges,20% of total billed charges,27.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.05,65,,,percent of total billed charges,65% of total billed charges,89.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.68,93.16,
ESCITALOPRAM TAB [10 MG],3500300,CDM,250,RC,J3490,HCPCS,outpatient,,,21.9,10.95,,14.24,65,,,percent of total billed charges,65% of total billed charges,14.89,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.38,20,,,percent of total billed charges,20% of total billed charges,4.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.38,20,,,percent of total billed charges,20% of total billed charges,4.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.24,65,,,percent of total billed charges,65% of total billed charges,14.24,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.38,53.67,
ESOPHAGUS-BARIUM SW,3400059,CDM,320,RC,74210,HCPCS,outpatient,,,249.7,124.85,,162.31,65,,,percent of total billed charges,65% of total billed charges,169.8,68,,,percent of total billed charges,68% of total billed charges,39.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.94,20,,,percent of total billed charges,20% of total billed charges,49.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.94,20,,,percent of total billed charges,20% of total billed charges,49.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.31,65,,,percent of total billed charges,65% of total billed charges,162.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.46,180,
ESOPHAGUS-BARIUM SW,3440057,CDM,972,RC,74210,HCPCS,outpatient,,,133.1,66.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.73,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,104.58,110,,,fee schedule,110% of Medicare physician fee schedule,104.58,110,,,fee schedule,110% of Medicare physician fee schedule,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,285.73,115,,,fee schedule,115% of Medicare physician fee schedule,93.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.73,285.73,
ESOPHOGRAM,3400200,CDM,320,RC,74220,HCPCS,outpatient,,,91.12,45.56,,59.23,65,,,percent of total billed charges,65% of total billed charges,61.96,68,,,percent of total billed charges,68% of total billed charges,39.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.22,20,,,percent of total billed charges,20% of total billed charges,18.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.22,20,,,percent of total billed charges,20% of total billed charges,18.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.23,65,,,percent of total billed charges,65% of total billed charges,59.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.22,180,
ESOPHOGRAM,3440469,CDM,972,RC,74220,HCPCS,outpatient,,,88,44,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,48.34,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,96.8,110,,,fee schedule,110% of Medicare physician fee schedule,96.8,110,,,fee schedule,110% of Medicare physician fee schedule,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,277.6,115,,,fee schedule,115% of Medicare physician fee schedule,100.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.34,277.6,
ESTRADIOL,3300241,CDM,301,RC,82670,HCPCS,outpatient,,,122,61,,79.3,65,,,percent of total billed charges,65% of total billed charges,82.96,68,,,percent of total billed charges,68% of total billed charges,39.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.4,20,,,percent of total billed charges,20% of total billed charges,24.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.4,20,,,percent of total billed charges,20% of total billed charges,24.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.3,65,,,percent of total billed charges,65% of total billed charges,79.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.4,82.96,
ESTRADIOL TAB [0.5 MG],3500305,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ESTROGEN TOTAL,3300221,CDM,301,RC,82672,HCPCS,outpatient,,,120,60,,78,65,,,percent of total billed charges,65% of total billed charges,81.6,68,,,percent of total billed charges,68% of total billed charges,30.78,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,65,,,percent of total billed charges,65% of total billed charges,78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,81.6,
ET TUBE,3170029,CDM,272,RC,,,outpatient,,,36,18,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,20,,,percent of total billed charges,20% of total billed charges,7.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,20,,,percent of total billed charges,20% of total billed charges,7.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.4,65,,,percent of total billed charges,65% of total billed charges,23.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,53.67,
ET TUBE,3220237,CDM,272,RC,,,outpatient,,,18.3,9.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.66,20,,,percent of total billed charges,20% of total billed charges,3.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.66,20,,,percent of total billed charges,20% of total billed charges,3.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.9,65,,,percent of total billed charges,65% of total billed charges,11.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,53.67,
ET TUBE 5.5,6215900,CDM,272,RC,,,outpatient,,,10.1,5.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.02,20,,,percent of total billed charges,20% of total billed charges,2.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.02,20,,,percent of total billed charges,20% of total billed charges,2.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,65,,,percent of total billed charges,65% of total billed charges,6.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.02,53.67,
ET TUBE HOLDER,3170115,CDM,272,RC,,,outpatient,,,18.45,9.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.69,20,,,percent of total billed charges,20% of total billed charges,3.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.69,20,,,percent of total billed charges,20% of total billed charges,3.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.99,65,,,percent of total billed charges,65% of total billed charges,11.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.69,53.67,
ETOMIDATE INJ [2 MG/ML],3500311,CDM,636,RC,J3490,HCPCS,outpatient,,,49.95,24.98,,,,,,other,Not reimbursable per contract ,33.97,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.99,20,,,percent of total billed charges,20% of total billed charges,9.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.99,20,,,percent of total billed charges,20% of total billed charges,9.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.96,80,,,case rate,80% for high cost drug carve out,42.46,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.99,42.46,
EVAL OF SPEECH FLUENCY,3600037,CDM,440,RC,92521,HCPCS,outpatient,,,169,84.5,,109.85,65,,,percent of total billed charges,65% of total billed charges,114.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.85,65,,,percent of total billed charges,65% of total billed charges,109.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.8,114.92,
EVAL OF SPEECH SOUND PRODUCTION,3600095,CDM,440,RC,92522,HCPCS,outpatient,,,169,84.5,,109.85,65,,,percent of total billed charges,65% of total billed charges,114.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.85,65,,,percent of total billed charges,65% of total billed charges,109.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.8,114.92,
EVAL OF SPEECH W/EVAL OF LANG COMP & EXP,3600096,CDM,440,RC,92523,HCPCS,outpatient,,,169,84.5,,109.85,65,,,percent of total billed charges,65% of total billed charges,114.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,20,,,percent of total billed charges,20% of total billed charges,33.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.85,65,,,percent of total billed charges,65% of total billed charges,109.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,101.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.8,114.92,
EXC B9 LESION  XCP SK TAG T/A/L .5CM,3462055,CDM,982,RC,11400,HCPCS,outpatient,,,165,82.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.77,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.25,110,,,fee schedule,110% of Medicare physician fee schedule,92.25,110,,,fee schedule,110% of Medicare physician fee schedule,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,96.44,115,,,fee schedule,115% of Medicare physician fee schedule,108.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.77,108.37,
EXC BENIGN LESION 1.1-2.0 CM,3700315,CDM,510,RC,11402,HCPCS,outpatient,,,380,190,,247,65,,,percent of total billed charges,65% of total billed charges,258.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76,20,,,percent of total billed charges,20% of total billed charges,76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76,20,,,percent of total billed charges,20% of total billed charges,76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,247,65,,,percent of total billed charges,65% of total billed charges,247,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,228,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,296,
EXC BENIGN LESION 1.1-2.0 CM PRO FEE,3700316,CDM,983,RC,11402,HCPCS,outpatient,,,190,95,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,752,100,,,fee schedule,100% Medicare fee schedule rate for Anesthesia,127.74,100,,,fee schedule,100% Medicare fee schedule rate for Anesthesia,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.55,115,,,fee schedule,115% of Medicare physician fee schedule,130.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.28,752,
EXC BENIGN LESION T/A/L /<.5CM,3700318,CDM,983,RC,11400,HCPCS,outpatient,,,110,55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.77,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.25,110,,,fee schedule,110% of Medicare physician fee schedule,92.25,110,,,fee schedule,110% of Medicare physician fee schedule,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,96.44,115,,,fee schedule,115% of Medicare physician fee schedule,108.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.08,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.77,108.37,
EXC BENIGN LESION TRUNK ARMS LEGS </.5CM,3700317,CDM,510,RC,11400,HCPCS,outpatient,,,268,134,,174.2,65,,,percent of total billed charges,65% of total billed charges,182.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.6,20,,,percent of total billed charges,20% of total billed charges,53.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.6,20,,,percent of total billed charges,20% of total billed charges,53.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.2,65,,,percent of total billed charges,65% of total billed charges,174.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.6,296,
EXC H-F-N-SP BENIGN + MARG >4CM,3060415,CDM,360,RC,11426,HCPCS,outpatient,,,910,455,,591.5,65,,,percent of total billed charges,65% of total billed charges,618.8,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,20,,,percent of total billed charges,20% of total billed charges,182,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,20,,,percent of total billed charges,20% of total billed charges,182,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,591.5,65,,,percent of total billed charges,65% of total billed charges,591.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1478,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,546,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1478,
EXC H/F/NK/SP B9+MARG >4CM PRO FEE,3462110,CDM,982,RC,11426,HCPCS,outpatient,,,456,228,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,184.6,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,303.24,110,,,fee schedule,110% of Medicare physician fee schedule,303.24,110,,,fee schedule,110% of Medicare physician fee schedule,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,317.02,115,,,fee schedule,115% of Medicare physician fee schedule,237.2,100,,,fee schedule,100% of FL Medicaid fee schedule ,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,184.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,348.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,184.6,348.72,
EXC RECTUM TUMOR,3462116,CDM,982,RC,45172,HCPCS,outpatient,,,850,425,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,585.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,929.41,110,,,fee schedule,110% of Medicare physician fee schedule,929.41,110,,,fee schedule,110% of Medicare physician fee schedule,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,971.66,115,,,fee schedule,115% of Medicare physician fee schedule,637.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,585.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1068.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,585.28,1068.82,
EXC THROMBOSED HEMORRHOID XTRNL,3462080,CDM,982,RC,46320,HCPCS,outpatient,,,439,219.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,77.08,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.24,110,,,fee schedule,110% of Medicare physician fee schedule,127.24,110,,,fee schedule,110% of Medicare physician fee schedule,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.02,115,,,fee schedule,115% of Medicare physician fee schedule,129.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,77.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,77.08,146.32,
EXC TR-EXT B9+MARG 1.1-2CM PRO FEE,3462114,CDM,982,RC,11402,HCPCS,outpatient,,,280,140,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,752,100,,,fee schedule,100% Medicare fee schedule rate for Anesthesia,127.74,100,,,fee schedule,100% Medicare fee schedule rate for Anesthesia,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.55,115,,,fee schedule,115% of Medicare physician fee schedule,130.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.28,752,
EXC TR-EXT B9+MARG 3.1-4CM PRO FEE,3462113,CDM,982,RC,11404,HCPCS,outpatient,,,280,140,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,111,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,183.43,110,,,fee schedule,110% of Medicare physician fee schedule,183.43,110,,,fee schedule,110% of Medicare physician fee schedule,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.76,115,,,fee schedule,115% of Medicare physician fee schedule,163.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,111,100,,,fee schedule,100% of FL Medicaid fee schedule ,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,210.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,111,210.94,
EXC TR-EXT B9+MARG>4.0 CM PRO FEE,3462111,CDM,982,RC,11406,HCPCS,outpatient,,,375,187.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,168.68,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,279.19,110,,,fee schedule,110% of Medicare physician fee schedule,279.19,110,,,fee schedule,110% of Medicare physician fee schedule,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,291.88,115,,,fee schedule,115% of Medicare physician fee schedule,221.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,321.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.68,321.07,
EXC TR-EXT BENIGN+MARG >4.0CO,3060416,CDM,360,RC,11406,HCPCS,outpatient,,,826,413,,536.9,65,,,percent of total billed charges,65% of total billed charges,561.68,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,165.2,20,,,percent of total billed charges,20% of total billed charges,165.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,165.2,20,,,percent of total billed charges,20% of total billed charges,165.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,536.9,65,,,percent of total billed charges,65% of total billed charges,536.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,495.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,665,
EXC TR-EXT BENIGN+MARG 1.1-2CM,3060419,CDM,361,RC,11402,HCPCS,outpatient,,,560,280,,364,65,,,percent of total billed charges,65% of total billed charges,380.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112,20,,,percent of total billed charges,20% of total billed charges,112,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112,20,,,percent of total billed charges,20% of total billed charges,112,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,364,65,,,percent of total billed charges,65% of total billed charges,364,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,336,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,380.8,
EXC TR-EXT BENIGN+MARG 3.1-4CM,3060418,CDM,361,RC,11404,HCPCS,outpatient,,,537,268.5,,349.05,65,,,percent of total billed charges,65% of total billed charges,365.16,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.4,20,,,percent of total billed charges,20% of total billed charges,107.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.4,20,,,percent of total billed charges,20% of total billed charges,107.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,349.05,65,,,percent of total billed charges,65% of total billed charges,349.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,665,
EXC TR-EXTM B9+MARG 2.1-3CM,3462118,CDM,982,RC,11403,HCPCS,outpatient,,,660,330,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,100.38,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.18,110,,,fee schedule,110% of Medicare physician fee schedule,165.18,110,,,fee schedule,110% of Medicare physician fee schedule,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,172.68,115,,,fee schedule,115% of Medicare physician fee schedule,152.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,189.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,100.38,189.95,
EXCISION MULTIPLE EXTERNAL HEMORRHOIDS,3462012,CDM,982,RC,46230,HCPCS,outpatient,,,395,197.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,117.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,195.73,110,,,fee schedule,110% of Medicare physician fee schedule,195.73,110,,,fee schedule,110% of Medicare physician fee schedule,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,204.63,115,,,fee schedule,115% of Medicare physician fee schedule,170.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,117.91,225.09,
EXCISION NAIL MATRIX PERM REMOVAL,3700314,CDM,983,RC,11750,HCPCS,outpatient,,,204,102,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.53,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.58,110,,,fee schedule,110% of Medicare physician fee schedule,110.58,110,,,fee schedule,110% of Medicare physician fee schedule,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,115.61,115,,,fee schedule,115% of Medicare physician fee schedule,121.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.53,127.17,
EXCISION NAIL MATRIX PERM RMVL,3700313,CDM,510,RC,11750,HCPCS,outpatient,,,324,162,,210.6,65,,,percent of total billed charges,65% of total billed charges,220.32,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,20,,,percent of total billed charges,20% of total billed charges,64.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,20,,,percent of total billed charges,20% of total billed charges,64.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210.6,65,,,percent of total billed charges,65% of total billed charges,210.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,220.32,
EXCISION OF NAIL,3231079,CDM,450,RC,11750,HCPCS,outpatient,,,423,211.5,,274.95,65,,,percent of total billed charges,65% of total billed charges,287.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.6,20,,,percent of total billed charges,20% of total billed charges,84.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.6,20,,,percent of total billed charges,20% of total billed charges,84.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,274.95,65,,,percent of total billed charges,65% of total billed charges,274.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,287.64,
EXCISION PILONIDAL CYST/SINUS COMPLICATE,3462052,CDM,982,RC,11772,HCPCS,outpatient,,,990,495,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,399.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,656.08,110,,,fee schedule,110% of Medicare physician fee schedule,656.08,110,,,fee schedule,110% of Medicare physician fee schedule,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,685.91,115,,,fee schedule,115% of Medicare physician fee schedule,451.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,399.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,754.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,399.28,754.5,
EXCISION PILONIDAL CYST/SINUS EXTENSIVE,3462051,CDM,982,RC,11771,HCPCS,outpatient,,,818,409,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,304.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,512.24,110,,,fee schedule,110% of Medicare physician fee schedule,512.24,110,,,fee schedule,110% of Medicare physician fee schedule,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,535.52,115,,,fee schedule,115% of Medicare physician fee schedule,357.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,304.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,589.07,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,304.95,589.07,
EXCISION PILONIDAL CYST/SINUS SIMPLE,3462050,CDM,982,RC,11770,HCPCS,outpatient,,,418,209,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,127.61,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.65,110,,,fee schedule,110% of Medicare physician fee schedule,211.65,110,,,fee schedule,110% of Medicare physician fee schedule,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.27,115,,,fee schedule,115% of Medicare physician fee schedule,180.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.61,100,,,fee schedule,100% of FL Medicaid fee schedule ,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,243.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,127.61,243.4,
EXCISION SINGL EXTERNAL PAPILLA/TAG ANUS,3462078,CDM,982,RC,46220,HCPCS,outpatient,,,303,151.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,136.66,110,,,fee schedule,110% of Medicare physician fee schedule,136.66,110,,,fee schedule,110% of Medicare physician fee schedule,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.88,115,,,fee schedule,115% of Medicare physician fee schedule,134.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,157.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.1,157.16,
EXELON [9.5/24] PATCH,3501013,CDM,250,RC,J3490,HCPCS,outpatient,,,137.2,68.6,,89.18,65,,,percent of total billed charges,65% of total billed charges,93.3,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.44,20,,,percent of total billed charges,20% of total billed charges,27.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.44,20,,,percent of total billed charges,20% of total billed charges,27.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.18,65,,,percent of total billed charges,65% of total billed charges,89.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.44,93.3,
EXELON PATCH 4.6MG,3511847,CDM,250,RC,,,outpatient,,,137.2,68.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.44,20,,,percent of total billed charges,20% of total billed charges,27.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.44,20,,,percent of total billed charges,20% of total billed charges,27.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.18,65,,,percent of total billed charges,65% of total billed charges,89.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.44,89.18,
EXERCISE PULSE OX-MULTI,3170096,CDM,460,RC,94618,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,47.93,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40,207,
EXHALED CO2,3170121,CDM,460,RC,94681,HCPCS,outpatient,,,199.41,99.71,,129.62,65,,,percent of total billed charges,65% of total billed charges,135.6,68,,,percent of total billed charges,68% of total billed charges,48.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.88,20,,,percent of total billed charges,20% of total billed charges,39.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.88,20,,,percent of total billed charges,20% of total billed charges,39.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.62,65,,,percent of total billed charges,65% of total billed charges,129.62,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.88,207,
EYE FOR FOREIGN BODY,3400018,CDM,320,RC,70030,HCPCS,outpatient,,,111,55.5,,72.15,65,,,percent of total billed charges,65% of total billed charges,75.48,68,,,percent of total billed charges,68% of total billed charges,14.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.2,20,,,percent of total billed charges,20% of total billed charges,22.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.2,20,,,percent of total billed charges,20% of total billed charges,22.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.15,65,,,percent of total billed charges,65% of total billed charges,72.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,180,
EYE FOREIGN BODY,3440059,CDM,972,RC,70030,HCPCS,outpatient,,,52,26,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.11,110,,,fee schedule,110% of Medicare physician fee schedule,35.11,110,,,fee schedule,110% of Medicare physician fee schedule,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.11,115,,,fee schedule,115% of Medicare physician fee schedule,67.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.14,213.11,
EYE PAD OVAL STERILE,3250405,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
EZ I O 25 MM SET,3250655,CDM,272,RC,,,outpatient,,,192.85,96.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.57,20,,,percent of total billed charges,20% of total billed charges,38.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.57,20,,,percent of total billed charges,20% of total billed charges,38.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.35,65,,,percent of total billed charges,65% of total billed charges,125.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.57,125.35,
EZ-I O 15 MM SET,3250654,CDM,272,RC,,,outpatient,,,192.85,96.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.57,20,,,percent of total billed charges,20% of total billed charges,38.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.57,20,,,percent of total billed charges,20% of total billed charges,38.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.35,65,,,percent of total billed charges,65% of total billed charges,125.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.57,125.35,
EZ-IO 45MM SET,3250678,CDM,272,RC,,,outpatient,,,192.85,96.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.57,20,,,percent of total billed charges,20% of total billed charges,38.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.57,20,,,percent of total billed charges,20% of total billed charges,38.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.35,65,,,percent of total billed charges,65% of total billed charges,125.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.57,125.35,
EZETIMIBE TAB [10 MG],3500312,CDM,250,RC,J3490,HCPCS,outpatient,,,51.65,25.83,,33.57,65,,,percent of total billed charges,65% of total billed charges,35.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.33,20,,,percent of total billed charges,20% of total billed charges,10.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.33,20,,,percent of total billed charges,20% of total billed charges,10.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.57,65,,,percent of total billed charges,65% of total billed charges,33.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.33,53.67,
F D P,3300675,CDM,305,RC,85362,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,9.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,30.6,
FACIAL BONES MIN 3 V,3440061,CDM,972,RC,70150,HCPCS,outpatient,,,70.4,35.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.36,110,,,fee schedule,110% of Medicare physician fee schedule,50.36,110,,,fee schedule,110% of Medicare physician fee schedule,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.05,115,,,fee schedule,115% of Medicare physician fee schedule,75.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.71,229.05,
FACIAL BONES MIN 3VI,3400019,CDM,320,RC,70150,HCPCS,outpatient,,,178,89,,115.7,65,,,percent of total billed charges,65% of total billed charges,121.04,68,,,percent of total billed charges,68% of total billed charges,26.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.6,20,,,percent of total billed charges,20% of total billed charges,35.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.6,20,,,percent of total billed charges,20% of total billed charges,35.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.7,65,,,percent of total billed charges,65% of total billed charges,115.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.36,180,
FACTOR V,3300687,CDM,305,RC,85220,HCPCS,outpatient,,,178.5,89.25,,116.03,65,,,percent of total billed charges,65% of total billed charges,121.38,68,,,percent of total billed charges,68% of total billed charges,25.05,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.7,20,,,percent of total billed charges,20% of total billed charges,35.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.7,20,,,percent of total billed charges,20% of total billed charges,35.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,116.03,65,,,percent of total billed charges,65% of total billed charges,116.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,107.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,121.38,
FAMOTIDINE INJ [10 MG/ML],3500313,CDM,250,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
FAMOTIDINE PREMIX (20 MG/,3500956,CDM,250,RC,,,outpatient,,,25.95,12.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.19,20,,,percent of total billed charges,20% of total billed charges,5.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.19,20,,,percent of total billed charges,20% of total billed charges,5.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.87,65,,,percent of total billed charges,65% of total billed charges,16.87,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.19,53.67,
FAMOTIDINE TAB [20 MG],3500314,CDM,250,RC,J3490,HCPCS,outpatient,,,15.15,7.58,,9.85,65,,,percent of total billed charges,65% of total billed charges,10.3,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.03,20,,,percent of total billed charges,20% of total billed charges,3.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.03,20,,,percent of total billed charges,20% of total billed charges,3.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.85,65,,,percent of total billed charges,65% of total billed charges,9.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,53.67,
FAT/LIPIDS FECES; QUAL,3300859,CDM,301,RC,82705,HCPCS,outpatient,,,10,5,,6.5,65,,,percent of total billed charges,65% of total billed charges,6.8,68,,,percent of total billed charges,68% of total billed charges,7.23,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.5,65,,,percent of total billed charges,65% of total billed charges,6.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2,7.23,
FB AUDITORY CANL,3230995,CDM,450,RC,69200,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,178,
FB CORNEAL W/LAMP,3231105,CDM,450,RC,65222,HCPCS,outpatient,,,231,115.5,,150.15,65,,,percent of total billed charges,65% of total billed charges,157.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,20,,,percent of total billed charges,20% of total billed charges,46.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,20,,,percent of total billed charges,20% of total billed charges,46.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.15,65,,,percent of total billed charges,65% of total billed charges,150.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,178,
FB CORNEAL W/O LAMP,3231103,CDM,450,RC,65220,HCPCS,outpatient,,,221,110.5,,143.65,65,,,percent of total billed charges,65% of total billed charges,150.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,20,,,percent of total billed charges,20% of total billed charges,44.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,20,,,percent of total billed charges,20% of total billed charges,44.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143.65,65,,,percent of total billed charges,65% of total billed charges,143.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.2,178,
FB EYE CONJ EMBD,3231101,CDM,450,RC,65210,HCPCS,outpatient,,,231,115.5,,150.15,65,,,percent of total billed charges,65% of total billed charges,157.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,20,,,percent of total billed charges,20% of total billed charges,46.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,20,,,percent of total billed charges,20% of total billed charges,46.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.15,65,,,percent of total billed charges,65% of total billed charges,150.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,178,
FB EYE CONJ SUPERF,3231099,CDM,450,RC,65205,HCPCS,outpatient,,,221,110.5,,143.65,65,,,percent of total billed charges,65% of total billed charges,150.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,20,,,percent of total billed charges,20% of total billed charges,44.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,20,,,percent of total billed charges,20% of total billed charges,44.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143.65,65,,,percent of total billed charges,65% of total billed charges,143.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.2,178,
FB IMPACTED CERUMEN,3231107,CDM,450,RC,69210,HCPCS,outpatient,,,94,47,,61.1,65,,,percent of total billed charges,65% of total billed charges,63.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.1,65,,,percent of total billed charges,65% of total billed charges,61.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.8,178,
FB INTRANASAL,3231095,CDM,450,RC,30300,HCPCS,outpatient,,,141,70.5,,91.65,65,,,percent of total billed charges,65% of total billed charges,95.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,20,,,percent of total billed charges,20% of total billed charges,28.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,20,,,percent of total billed charges,20% of total billed charges,28.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.65,65,,,percent of total billed charges,65% of total billed charges,91.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,178,
FB MUSCLE DEEP COMP,3231093,CDM,450,RC,20525,HCPCS,outpatient,,,1280,640,,832,65,,,percent of total billed charges,65% of total billed charges,870.4,68,,,percent of total billed charges,68% of total billed charges,479,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,256,20,,,percent of total billed charges,20% of total billed charges,256,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,256,20,,,percent of total billed charges,20% of total billed charges,256,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,832,65,,,percent of total billed charges,65% of total billed charges,832,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1478,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1478,
FB MUSCLE SIMPLE,3231091,CDM,450,RC,20520,HCPCS,outpatient,,,852,426,,553.8,65,,,percent of total billed charges,65% of total billed charges,579.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.4,20,,,percent of total billed charges,20% of total billed charges,170.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.4,20,,,percent of total billed charges,20% of total billed charges,170.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,553.8,65,,,percent of total billed charges,65% of total billed charges,553.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,511.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,579.36,
FB PHARYNX,3231097,CDM,450,RC,42809,HCPCS,outpatient,,,265,132.5,,172.25,65,,,percent of total billed charges,65% of total billed charges,180.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53,20,,,percent of total billed charges,20% of total billed charges,53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53,20,,,percent of total billed charges,20% of total billed charges,53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,172.25,65,,,percent of total billed charges,65% of total billed charges,172.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53,180.2,
FB REMOVAL-VAGINA,3231092,CDM,450,RC,57415,HCPCS,outpatient,,,1684,842,,1094.6,65,,,percent of total billed charges,65% of total billed charges,1145.12,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,336.8,20,,,percent of total billed charges,20% of total billed charges,336.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,336.8,20,,,percent of total billed charges,20% of total billed charges,336.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1094.6,65,,,percent of total billed charges,65% of total billed charges,1094.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1478,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1010.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1478,
FB SUBCUTANEOUS COMP,3231089,CDM,450,RC,10121,HCPCS,outpatient,,,1280,640,,832,65,,,percent of total billed charges,65% of total billed charges,870.4,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,256,20,,,percent of total billed charges,20% of total billed charges,256,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,256,20,,,percent of total billed charges,20% of total billed charges,256,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,832,65,,,percent of total billed charges,65% of total billed charges,832,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,768,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,870.4,
FB SUBCUTANEOUS SIMP,3231087,CDM,450,RC,10120,HCPCS,outpatient,,,204,102,,132.6,65,,,percent of total billed charges,65% of total billed charges,138.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,65,,,percent of total billed charges,65% of total billed charges,132.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,178,
FEBRILE AGGLUTININS,3300475,CDM,302,RC,86000,HCPCS,outpatient,,,108,54,,70.2,65,,,percent of total billed charges,65% of total billed charges,73.44,68,,,percent of total billed charges,68% of total billed charges,9.91,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.6,20,,,percent of total billed charges,20% of total billed charges,21.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.6,20,,,percent of total billed charges,20% of total billed charges,21.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.2,65,,,percent of total billed charges,65% of total billed charges,70.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.91,73.44,
FECAL FAT QUANT,3300423,CDM,301,RC,82710,HCPCS,outpatient,,,59.54,29.77,,38.7,65,,,percent of total billed charges,65% of total billed charges,40.49,68,,,percent of total billed charges,68% of total billed charges,21.88,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.91,20,,,percent of total billed charges,20% of total billed charges,11.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.91,20,,,percent of total billed charges,20% of total billed charges,11.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.7,65,,,percent of total billed charges,65% of total billed charges,38.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.77,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.91,40.49,
FECAL LEUKOCYTES,3300745,CDM,306,RC,89055,HCPCS,outpatient,,,30,15,,19.5,65,,,percent of total billed charges,65% of total billed charges,20.4,68,,,percent of total billed charges,68% of total billed charges,6.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,20.4,
FEMUR BIL MIN 2 V,3440063,CDM,972,RC,73552,HCPCS,outpatient,,,86.9,43.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.27,110,,,fee schedule,110% of Medicare physician fee schedule,38.27,110,,,fee schedule,110% of Medicare physician fee schedule,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,216.41,115,,,fee schedule,115% of Medicare physician fee schedule,70.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.86,216.41,
FEMUR LT MIN 2 V,3440065,CDM,972,RC,73552,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.27,110,,,fee schedule,110% of Medicare physician fee schedule,38.27,110,,,fee schedule,110% of Medicare physician fee schedule,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,216.41,115,,,fee schedule,115% of Medicare physician fee schedule,70.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.86,216.41,
FEMUR RT MIN 2 V,3440067,CDM,972,RC,73552,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.27,110,,,fee schedule,110% of Medicare physician fee schedule,38.27,110,,,fee schedule,110% of Medicare physician fee schedule,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,216.41,115,,,fee schedule,115% of Medicare physician fee schedule,70.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.86,216.41,
FEMUR-BIL MIN 2 VIEW,3400073,CDM,320,RC,73552,HCPCS,outpatient,,,212,106,,137.8,65,,,percent of total billed charges,65% of total billed charges,144.16,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.8,65,,,percent of total billed charges,65% of total billed charges,137.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
FEMUR-L MIN 2 VIEW,3400020,CDM,320,RC,73552,HCPCS,outpatient,,,190.3,95.15,,123.7,65,,,percent of total billed charges,65% of total billed charges,129.4,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.06,20,,,percent of total billed charges,20% of total billed charges,38.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.06,20,,,percent of total billed charges,20% of total billed charges,38.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.7,65,,,percent of total billed charges,65% of total billed charges,123.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
FEMUR-R MIN 2 VIEW,3400072,CDM,320,RC,73552,HCPCS,outpatient,,,190.3,95.15,,123.7,65,,,percent of total billed charges,65% of total billed charges,129.4,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.06,20,,,percent of total billed charges,20% of total billed charges,38.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.06,20,,,percent of total billed charges,20% of total billed charges,38.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.7,65,,,percent of total billed charges,65% of total billed charges,123.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
FENOFIBRATE 160 MG,3501230,CDM,250,RC,,,outpatient,,,16.15,8.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.23,20,,,percent of total billed charges,20% of total billed charges,3.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.23,20,,,percent of total billed charges,20% of total billed charges,3.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.5,65,,,percent of total billed charges,65% of total billed charges,10.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.23,53.67,
FENOFIBRATE TAB [145 MG],3500316,CDM,250,RC,J3490,HCPCS,outpatient,,,5.6,2.8,,3.64,65,,,percent of total billed charges,65% of total billed charges,3.81,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.12,20,,,percent of total billed charges,20% of total billed charges,1.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.12,20,,,percent of total billed charges,20% of total billed charges,1.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.64,65,,,percent of total billed charges,65% of total billed charges,3.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.12,53.67,
FENOFIBRATE TAB [54 MG],3501031,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FENTANYL INJ [0.1 MG/2 ML,3500318,CDM,636,RC,J3010,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
FENTANYL PAT [100 MCG/HR],3500319,CDM,250,RC,J3490,HCPCS,outpatient,,,106.85,53.43,,69.45,65,,,percent of total billed charges,65% of total billed charges,72.66,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.37,20,,,percent of total billed charges,20% of total billed charges,21.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.37,20,,,percent of total billed charges,20% of total billed charges,21.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.45,65,,,percent of total billed charges,65% of total billed charges,69.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.37,72.66,
FENTANYL PAT [12 MCG/HR],3500965,CDM,250,RC,J3490,HCPCS,outpatient,,,40.6,20.3,,26.39,65,,,percent of total billed charges,65% of total billed charges,27.61,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.12,20,,,percent of total billed charges,20% of total billed charges,8.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.12,20,,,percent of total billed charges,20% of total billed charges,8.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.39,65,,,percent of total billed charges,65% of total billed charges,26.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.12,53.67,
FENTANYL PAT [25 MCG/HR],3500320,CDM,250,RC,J3490,HCPCS,outpatient,,,42.55,21.28,,27.66,65,,,percent of total billed charges,65% of total billed charges,28.93,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.51,20,,,percent of total billed charges,20% of total billed charges,8.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.51,20,,,percent of total billed charges,20% of total billed charges,8.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.66,65,,,percent of total billed charges,65% of total billed charges,27.66,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.51,53.67,
FENTANYL PAT [50 MCG/HR],3500321,CDM,250,RC,J3490,HCPCS,outpatient,,,77.8,38.9,,50.57,65,,,percent of total billed charges,65% of total billed charges,52.9,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.56,20,,,percent of total billed charges,20% of total billed charges,15.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.56,20,,,percent of total billed charges,20% of total billed charges,15.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.57,65,,,percent of total billed charges,65% of total billed charges,50.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.56,53.67,
FENTANYL PAT [75 MCG/HR],3500322,CDM,250,RC,J3490,HCPCS,outpatient,,,80.45,40.23,,52.29,65,,,percent of total billed charges,65% of total billed charges,54.71,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.09,20,,,percent of total billed charges,20% of total billed charges,16.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.09,20,,,percent of total billed charges,20% of total billed charges,16.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.29,65,,,percent of total billed charges,65% of total billed charges,52.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.09,54.71,
FERRITIN,3300173,CDM,301,RC,82728,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,19.33,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
FERROUS SULF LIQ [220 MG/,3500323,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FERROUS SULF TAB [325 MG],3500325,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FIBRINOGEN,3300655,CDM,305,RC,85384,HCPCS,outpatient,,,67,33.5,,43.55,65,,,percent of total billed charges,65% of total billed charges,45.56,68,,,percent of total billed charges,68% of total billed charges,12.05,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.4,20,,,percent of total billed charges,20% of total billed charges,13.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.4,20,,,percent of total billed charges,20% of total billed charges,13.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.55,65,,,percent of total billed charges,65% of total billed charges,43.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.05,45.56,
FIBRO TEST (LIVER FIBROSIS),3300928,CDM,301,RC,81596,HCPCS,outpatient,,,300.3,150.15,,195.2,65,,,percent of total billed charges,65% of total billed charges,204.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.06,20,,,percent of total billed charges,20% of total billed charges,60.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.06,20,,,percent of total billed charges,20% of total billed charges,60.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195.2,65,,,percent of total billed charges,65% of total billed charges,195.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.06,204.2,
FINASTERIDE TAB [5 MG],3500327,CDM,250,RC,J3490,HCPCS,outpatient,,,15.65,7.83,,10.17,65,,,percent of total billed charges,65% of total billed charges,10.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.13,20,,,percent of total billed charges,20% of total billed charges,3.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.13,20,,,percent of total billed charges,20% of total billed charges,3.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.17,65,,,percent of total billed charges,65% of total billed charges,10.17,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.13,53.67,
FINE FUSION DEVICE,6215830,CDM,272,RC,,,outpatient,,,616.25,308.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.25,20,,,percent of total billed charges,20% of total billed charges,123.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.25,20,,,percent of total billed charges,20% of total billed charges,123.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,400.56,65,,,percent of total billed charges,65% of total billed charges,400.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,400.56,
FINGER BIL MIN 2 V,3440069,CDM,972,RC,73140,HCPCS,outpatient,,,60.5,30.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.61,110,,,fee schedule,110% of Medicare physician fee schedule,40.61,110,,,fee schedule,110% of Medicare physician fee schedule,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,218.86,115,,,fee schedule,115% of Medicare physician fee schedule,69.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.7,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,218.86,
FINGER LT MIN 2 V,3440071,CDM,972,RC,73140,HCPCS,outpatient,,,36.3,18.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.93,110,,,fee schedule,110% of Medicare physician fee schedule,39.93,110,,,fee schedule,110% of Medicare physician fee schedule,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,218.15,115,,,fee schedule,115% of Medicare physician fee schedule,69.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,218.15,
FINGER RT MIN 2 V,3440073,CDM,972,RC,73140,HCPCS,outpatient,,,36.3,18.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.93,110,,,fee schedule,110% of Medicare physician fee schedule,39.93,110,,,fee schedule,110% of Medicare physician fee schedule,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,218.15,115,,,fee schedule,115% of Medicare physician fee schedule,69.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,218.15,
FINGER-BIL MIN 2 VIE,3400075,CDM,320,RC,73140,HCPCS,outpatient,,,178,89,,115.7,65,,,percent of total billed charges,65% of total billed charges,121.04,68,,,percent of total billed charges,68% of total billed charges,14.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.6,20,,,percent of total billed charges,20% of total billed charges,35.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.6,20,,,percent of total billed charges,20% of total billed charges,35.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.7,65,,,percent of total billed charges,65% of total billed charges,115.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,180,
FINGER-L MIN 2 VIEW,3400025,CDM,320,RC,73140,HCPCS,outpatient,,,138.6,69.3,,90.09,65,,,percent of total billed charges,65% of total billed charges,94.25,68,,,percent of total billed charges,68% of total billed charges,14.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,20,,,percent of total billed charges,20% of total billed charges,27.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,20,,,percent of total billed charges,20% of total billed charges,27.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.09,65,,,percent of total billed charges,65% of total billed charges,90.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,180,
FINGER-R MIN 2 VIEW,3400074,CDM,320,RC,73140,HCPCS,outpatient,,,138.6,69.3,,90.09,65,,,percent of total billed charges,65% of total billed charges,94.25,68,,,percent of total billed charges,68% of total billed charges,14.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,20,,,percent of total billed charges,20% of total billed charges,27.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,20,,,percent of total billed charges,20% of total billed charges,27.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.09,65,,,percent of total billed charges,65% of total billed charges,90.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,180,
FISH OIL CAP [1000 MG],3500330,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FISTULAGRAM,3400108,CDM,320,RC,76080,HCPCS,outpatient,,,421,210.5,,273.65,65,,,percent of total billed charges,65% of total billed charges,286.28,68,,,percent of total billed charges,68% of total billed charges,35.31,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.2,20,,,percent of total billed charges,20% of total billed charges,84.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.2,20,,,percent of total billed charges,20% of total billed charges,84.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,273.65,65,,,percent of total billed charges,65% of total billed charges,273.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.31,286.28,
FISTULAGRAM,3440393,CDM,972,RC,76080,HCPCS,outpatient,,,100,50,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.23,110,,,fee schedule,110% of Medicare physician fee schedule,65.23,110,,,fee schedule,110% of Medicare physician fee schedule,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,244.6,115,,,fee schedule,115% of Medicare physician fee schedule,82.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,75.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.28,244.6,
FISTULAGRAM INJ,3400132,CDM,361,RC,20501,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,178,
FISTULAGRAM INJ,3440425,CDM,972,RC,20501,HCPCS,outpatient,,,110,55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.15,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.87,110,,,fee schedule,110% of Medicare physician fee schedule,40.87,110,,,fee schedule,110% of Medicare physician fee schedule,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.72,115,,,fee schedule,115% of Medicare physician fee schedule,77.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.99,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.15,77.75,
FLATUS BAG,3250205,CDM,271,RC,,,outpatient,,,12.85,6.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.57,20,,,percent of total billed charges,20% of total billed charges,2.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.57,20,,,percent of total billed charges,20% of total billed charges,2.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.35,65,,,percent of total billed charges,65% of total billed charges,8.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.57,53.67,
FLEX SCREEN SIGMOID,3060267,CDM,750,RC,G0104,HCPCS,outpatient,,,1111,555.5,,722.15,65,,,percent of total billed charges,65% of total billed charges,755.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,222.2,20,,,percent of total billed charges,20% of total billed charges,222.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,222.2,20,,,percent of total billed charges,20% of total billed charges,222.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,722.15,65,,,percent of total billed charges,65% of total billed charges,722.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,666.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,755.48,
FLORASTOR CAP [250 MG],3500332,CDM,250,RC,J3490,HCPCS,outpatient,,,5.1,2.55,,3.32,65,,,percent of total billed charges,65% of total billed charges,3.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.02,20,,,percent of total billed charges,20% of total billed charges,1.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.02,20,,,percent of total billed charges,20% of total billed charges,1.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.32,65,,,percent of total billed charges,65% of total billed charges,3.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.02,53.67,
FLUCONAZOLE SUSP [40 MG/M,3500333,CDM,250,RC,J3490,HCPCS,outpatient,,,25.65,12.83,,16.67,65,,,percent of total billed charges,65% of total billed charges,17.44,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.13,20,,,percent of total billed charges,20% of total billed charges,5.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.13,20,,,percent of total billed charges,20% of total billed charges,5.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.67,65,,,percent of total billed charges,65% of total billed charges,16.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.13,53.67,
FLUCONAZOLE TAB [100 MG],3500334,CDM,250,RC,J3490,HCPCS,outpatient,,,44.05,22.03,,28.63,65,,,percent of total billed charges,65% of total billed charges,29.95,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.81,20,,,percent of total billed charges,20% of total billed charges,8.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.81,20,,,percent of total billed charges,20% of total billed charges,8.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.63,65,,,percent of total billed charges,65% of total billed charges,28.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.81,53.67,
FLUCONAZOLE/ SOD CL PREMI,3500336,CDM,636,RC,J1450,HCPCS,outpatient,,,48.6,24.3,,,,,,other,Not reimbursable per contract ,33.05,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,20,,,percent of total billed charges,20% of total billed charges,9.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,20,,,percent of total billed charges,20% of total billed charges,9.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.88,80,,,case rate,80% for high cost drug carve out,41.31,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,41.31,
FLUDROCORTISONE TAB [0.1,3500337,CDM,250,RC,J3490,HCPCS,outpatient,,,8,4,,5.2,65,,,percent of total billed charges,65% of total billed charges,5.44,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.6,20,,,percent of total billed charges,20% of total billed charges,1.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.6,20,,,percent of total billed charges,20% of total billed charges,1.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,65,,,percent of total billed charges,65% of total billed charges,5.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.6,53.67,
FLUMAZENIL INJ [0.5 MG/5,3500338,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
FLUORESCEIN SOD 1 MG [EYE,3500343,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FLUORO CENTRAL VENOUS ACCESS  PLACEMENT,3462009,CDM,982,RC,77001,HCPCS,outpatient,,,124,62,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.41,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,107.61,110,,,fee schedule,110% of Medicare physician fee schedule,107.61,110,,,fee schedule,110% of Medicare physician fee schedule,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,112.5,115,,,fee schedule,115% of Medicare physician fee schedule,99.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,123.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.41,123.75,
FLUORSCOPY =<1HR,3440075,CDM,972,RC,76000,HCPCS,outpatient,,,79,39.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.07,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.17,110,,,fee schedule,110% of Medicare physician fee schedule,47.17,110,,,fee schedule,110% of Medicare physician fee schedule,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.71,115,,,fee schedule,115% of Medicare physician fee schedule,82.67,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.07,225.71,
FLUORSCOPY/ 1HR,3400052,CDM,320,RC,76000,HCPCS,outpatient,,,234,117,,152.1,65,,,percent of total billed charges,65% of total billed charges,159.12,68,,,percent of total billed charges,68% of total billed charges,43.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,20,,,percent of total billed charges,20% of total billed charges,46.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,20,,,percent of total billed charges,20% of total billed charges,46.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.1,65,,,percent of total billed charges,65% of total billed charges,152.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.45,180,
FLUOXETINE,3300231,CDM,301,RC,80299,HCPCS,outpatient,,,99,49.5,,64.35,65,,,percent of total billed charges,65% of total billed charges,67.32,68,,,percent of total billed charges,68% of total billed charges,19.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,20,,,percent of total billed charges,20% of total billed charges,19.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,20,,,percent of total billed charges,20% of total billed charges,19.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.35,65,,,percent of total billed charges,65% of total billed charges,64.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.43,67.32,
FLUOXETINE CAP [10 MG],3500344,CDM,250,RC,J3490,HCPCS,outpatient,,,12.1,6.05,,7.87,65,,,percent of total billed charges,65% of total billed charges,8.23,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.42,20,,,percent of total billed charges,20% of total billed charges,2.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.42,20,,,percent of total billed charges,20% of total billed charges,2.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.87,65,,,percent of total billed charges,65% of total billed charges,7.87,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.42,53.67,
FLUOXETINE CAP [20 MG],3500345,CDM,250,RC,J3490,HCPCS,outpatient,,,12.45,6.23,,8.09,65,,,percent of total billed charges,65% of total billed charges,8.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.49,20,,,percent of total billed charges,20% of total billed charges,2.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.49,20,,,percent of total billed charges,20% of total billed charges,2.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.09,65,,,percent of total billed charges,65% of total billed charges,8.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,53.67,
FLUSH HEP-LOCK [100 UNT/M,3500346,CDM,250,RC,J1642,HCPCS,outpatient,,,15.4,7.7,,10.01,65,,,percent of total billed charges,65% of total billed charges,10.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.08,20,,,percent of total billed charges,20% of total billed charges,3.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.08,20,,,percent of total billed charges,20% of total billed charges,3.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.01,65,,,percent of total billed charges,65% of total billed charges,10.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,53.67,
FLUSH SOD CL 0.9%,3500347,CDM,250,RC,,,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,65,,,percent of total billed charges,65% of total billed charges,10.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.2,53.67,
FLUTICASONE MDI  [44 MCG],3500348,CDM,250,RC,J3490,HCPCS,outpatient,,,329.65,164.83,,214.27,65,,,percent of total billed charges,65% of total billed charges,224.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.93,20,,,percent of total billed charges,20% of total billed charges,65.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.93,20,,,percent of total billed charges,20% of total billed charges,65.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,214.27,65,,,percent of total billed charges,65% of total billed charges,214.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,197.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,224.16,
FLUTICASONE MDI [220 MCG],3500349,CDM,250,RC,J3490,HCPCS,outpatient,,,599.6,299.8,,389.74,65,,,percent of total billed charges,65% of total billed charges,407.73,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.92,20,,,percent of total billed charges,20% of total billed charges,119.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.92,20,,,percent of total billed charges,20% of total billed charges,119.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,389.74,65,,,percent of total billed charges,65% of total billed charges,389.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,359.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,407.73,
FLUTICASONE PROPIONATE HCL NAS SPR 50MG,3501114,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FOLATE RBC,3300171,CDM,301,RC,82747,HCPCS,outpatient,,,110,55,,71.5,65,,,percent of total billed charges,65% of total billed charges,74.8,68,,,percent of total billed charges,68% of total billed charges,4.25,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.5,65,,,percent of total billed charges,65% of total billed charges,71.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.25,74.8,
FOLEY 14 FR/2 WAY,3250595,CDM,272,RC,,,outpatient,,,38.45,19.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.69,20,,,percent of total billed charges,20% of total billed charges,7.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.69,20,,,percent of total billed charges,20% of total billed charges,7.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.99,65,,,percent of total billed charges,65% of total billed charges,24.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.69,53.67,
FOLEY 16 FR/ 2 WAY,3250028,CDM,272,RC,,,outpatient,,,29.85,14.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.97,20,,,percent of total billed charges,20% of total billed charges,5.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.97,20,,,percent of total billed charges,20% of total billed charges,5.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,65,,,percent of total billed charges,65% of total billed charges,19.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,53.67,
FOLEY 16 FR/3 WAY,3250591,CDM,272,RC,,,outpatient,,,68.8,34.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.76,20,,,percent of total billed charges,20% of total billed charges,13.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.76,20,,,percent of total billed charges,20% of total billed charges,13.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.72,65,,,percent of total billed charges,65% of total billed charges,44.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.76,53.67,
FOLEY 18 FR/2 WAY,3250029,CDM,272,RC,,,outpatient,,,48.75,24.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,20,,,percent of total billed charges,20% of total billed charges,9.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,20,,,percent of total billed charges,20% of total billed charges,9.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.69,65,,,percent of total billed charges,65% of total billed charges,31.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,53.67,
FOLEY 18 FR/3 WAY,3250593,CDM,272,RC,,,outpatient,,,84.9,42.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.98,20,,,percent of total billed charges,20% of total billed charges,16.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.98,20,,,percent of total billed charges,20% of total billed charges,16.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.19,65,,,percent of total billed charges,65% of total billed charges,55.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.98,55.19,
FOLEY 20 FR/3 WAY,3250597,CDM,272,RC,,,outpatient,,,84.05,42.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.81,20,,,percent of total billed charges,20% of total billed charges,16.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.81,20,,,percent of total billed charges,20% of total billed charges,16.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.63,65,,,percent of total billed charges,65% of total billed charges,54.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.81,54.63,
FOLEY 22 FR/2 WAY,3250690,CDM,272,RC,,,outpatient,,,49.65,24.83,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.93,20,,,percent of total billed charges,20% of total billed charges,9.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.93,20,,,percent of total billed charges,20% of total billed charges,9.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.27,65,,,percent of total billed charges,65% of total billed charges,32.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.93,53.67,
FOLEY 22FR/3WAY,3250599,CDM,272,RC,,,outpatient,,,37.5,18.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,20,,,percent of total billed charges,20% of total billed charges,7.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,20,,,percent of total billed charges,20% of total billed charges,7.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.38,65,,,percent of total billed charges,65% of total billed charges,24.38,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,53.67,
FOLIC ACID,3300103,CDM,301,RC,82746,HCPCS,outpatient,,,69.3,34.65,,45.05,65,,,percent of total billed charges,65% of total billed charges,47.12,68,,,percent of total billed charges,68% of total billed charges,20.87,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.86,20,,,percent of total billed charges,20% of total billed charges,13.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.86,20,,,percent of total billed charges,20% of total billed charges,13.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.05,65,,,percent of total billed charges,65% of total billed charges,45.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.65,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.86,47.12,
FOLIC ACID 5MG/ML IV,3521915,CDM,250,RC,,,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,65,,,percent of total billed charges,65% of total billed charges,10.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.2,53.67,
FOLIC ACID INJ [1 MG/0.2,3500351,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
FOLIC ACID TAB [1 MG],3500352,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FOOT BIL 2 VIEWS,3400118,CDM,320,RC,73620,HCPCS,outpatient,,,214,107,,139.1,65,,,percent of total billed charges,65% of total billed charges,145.52,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.8,20,,,percent of total billed charges,20% of total billed charges,42.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.8,20,,,percent of total billed charges,20% of total billed charges,42.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,139.1,65,,,percent of total billed charges,65% of total billed charges,139.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
FOOT BIL 2 VIEWS,3440403,CDM,972,RC,73620,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.51,110,,,fee schedule,110% of Medicare physician fee schedule,30.51,110,,,fee schedule,110% of Medicare physician fee schedule,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.3,115,,,fee schedule,115% of Medicare physician fee schedule,66.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,208.3,
FOOT BIL MIN 3 V,3440077,CDM,972,RC,73630,HCPCS,outpatient,,,86.9,43.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.85,110,,,fee schedule,110% of Medicare physician fee schedule,36.85,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.93,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,214.93,
FOOT LEFT 2 VIEW,3400119,CDM,320,RC,73620,HCPCS,outpatient,,,153,76.5,,99.45,65,,,percent of total billed charges,65% of total billed charges,104.04,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.45,65,,,percent of total billed charges,65% of total billed charges,99.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
FOOT LEFT 2 VIEW,3440405,CDM,972,RC,73620,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.51,110,,,fee schedule,110% of Medicare physician fee schedule,30.51,110,,,fee schedule,110% of Medicare physician fee schedule,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.3,115,,,fee schedule,115% of Medicare physician fee schedule,66.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,208.3,
FOOT LT MIN 3 V,3440079,CDM,972,RC,73630,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.85,110,,,fee schedule,110% of Medicare physician fee schedule,36.85,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.93,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,214.93,
FOOT RT 2 VIEW,3400120,CDM,320,RC,73620,HCPCS,outpatient,,,153,76.5,,99.45,65,,,percent of total billed charges,65% of total billed charges,104.04,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.45,65,,,percent of total billed charges,65% of total billed charges,99.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
FOOT RT 2 VIEW,3440407,CDM,972,RC,73620,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.51,110,,,fee schedule,110% of Medicare physician fee schedule,30.51,110,,,fee schedule,110% of Medicare physician fee schedule,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.3,115,,,fee schedule,115% of Medicare physician fee schedule,66.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.09,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,208.3,
FOOT RT MIN 3 V,3440081,CDM,972,RC,73630,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.85,110,,,fee schedule,110% of Medicare physician fee schedule,36.85,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.93,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,214.93,
FOOT-BIL MIN 3 VIEW,3400077,CDM,320,RC,73630,HCPCS,outpatient,,,175,87.5,,113.75,65,,,percent of total billed charges,65% of total billed charges,119,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.75,65,,,percent of total billed charges,65% of total billed charges,113.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
FOOT-LT MIN 3 VIEW,3400026,CDM,320,RC,73630,HCPCS,outpatient,,,165,82.5,,107.25,65,,,percent of total billed charges,65% of total billed charges,112.2,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.25,65,,,percent of total billed charges,65% of total billed charges,107.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
FOOT-RT MIN 3 VIEW,3400076,CDM,320,RC,73630,HCPCS,outpatient,,,165,82.5,,107.25,65,,,percent of total billed charges,65% of total billed charges,112.2,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,20,,,percent of total billed charges,20% of total billed charges,33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.25,65,,,percent of total billed charges,65% of total billed charges,107.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
FOREARM BIL MIN 2 V,3440083,CDM,972,RC,73090,HCPCS,outpatient,,,73,36.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.41,115,,,fee schedule,115% of Medicare physician fee schedule,66.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,209.41,
FOREARM LT MIN 2 V,3440085,CDM,972,RC,73090,HCPCS,outpatient,,,45.1,22.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.41,115,,,fee schedule,115% of Medicare physician fee schedule,66.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,209.41,
FOREARM RT MIN 2 V,3440087,CDM,972,RC,73090,HCPCS,outpatient,,,45.1,22.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,31.57,110,,,fee schedule,110% of Medicare physician fee schedule,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.41,115,,,fee schedule,115% of Medicare physician fee schedule,66.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.31,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.17,209.41,
FOREARM-BIL MIN 2 VIE,3400079,CDM,320,RC,73090,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
FOREARM-LTMIN 2 VIEW,3400027,CDM,320,RC,73090,HCPCS,outpatient,,,152.9,76.45,,99.39,65,,,percent of total billed charges,65% of total billed charges,103.97,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.58,20,,,percent of total billed charges,20% of total billed charges,30.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.58,20,,,percent of total billed charges,20% of total billed charges,30.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.39,65,,,percent of total billed charges,65% of total billed charges,99.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
FOREARM-RT MIN 2 VIEW,3400078,CDM,320,RC,73090,HCPCS,outpatient,,,152.9,76.45,,99.39,65,,,percent of total billed charges,65% of total billed charges,103.97,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.58,20,,,percent of total billed charges,20% of total billed charges,30.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.58,20,,,percent of total billed charges,20% of total billed charges,30.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.39,65,,,percent of total billed charges,65% of total billed charges,99.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
FOSPHENYTOIN SDV [50 MG/M,3500355,CDM,250,RC,J3490,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
FSH,3300175,CDM,301,RC,83001,HCPCS,outpatient,,,88,44,,57.2,65,,,percent of total billed charges,65% of total billed charges,59.84,68,,,percent of total billed charges,68% of total billed charges,26.38,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.2,65,,,percent of total billed charges,65% of total billed charges,57.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.6,59.84,
FTA-ABS,3300485,CDM,302,RC,86780,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,18.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,46.24,
FUNGAL CULTURE (SBH),3300707,CDM,306,RC,87102,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,11.92,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.92,61.2,
FUROSEMIDE INJ (20 MG/2 M,3500356,CDM,636,RC,J1940,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
FUROSEMIDE INJ [100 MG/10,3500357,CDM,636,RC,J1940,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
FUROSEMIDE INJ [40 MG/4 M,3500358,CDM,636,RC,J1940,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
FUROSEMIDE TAB [20 MG],3500360,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FUROSEMIDE TAB [40 MG],3500361,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
FUROSEMIDE TAB [80 MG],3500362,CDM,250,RC,J3490,HCPCS,outpatient,,,7.9,3.95,,5.14,65,,,percent of total billed charges,65% of total billed charges,5.37,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.58,20,,,percent of total billed charges,20% of total billed charges,1.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.58,20,,,percent of total billed charges,20% of total billed charges,1.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.14,65,,,percent of total billed charges,65% of total billed charges,5.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.58,53.67,
G TUBE PATENCY CK,3440421,CDM,972,RC,49465,HCPCS,outpatient,,,91,45.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.3,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.06,110,,,fee schedule,110% of Medicare physician fee schedule,34.06,110,,,fee schedule,110% of Medicare physician fee schedule,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.6,115,,,fee schedule,115% of Medicare physician fee schedule,72.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.3,72.9,
G-TUBE PATENCY CK,3400130,CDM,361,RC,49465,HCPCS,outpatient,,,300,150,,195,65,,,percent of total billed charges,65% of total billed charges,204,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,65,,,percent of total billed charges,65% of total billed charges,195,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,204,
GABAPENTIN CAP [100 MG],3500363,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GABAPENTIN CAP [300 MG],3500364,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GABAPENTIN CAP [400 MG],3500365,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GABAPENTIN TAB [600 MG],3500366,CDM,250,RC,J3490,HCPCS,outpatient,,,12.15,6.08,,7.9,65,,,percent of total billed charges,65% of total billed charges,8.26,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.43,20,,,percent of total billed charges,20% of total billed charges,2.43,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.43,20,,,percent of total billed charges,20% of total billed charges,2.43,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.9,65,,,percent of total billed charges,65% of total billed charges,7.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.43,53.67,
GABAPENTIN TAB [800 MG],3500367,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GAIT TRAINING/15M,3600001,CDM,420,RC,97116,HCPCS,outpatient,,,96,48,,62.4,65,,,percent of total billed charges,65% of total billed charges,65.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.4,65,,,percent of total billed charges,65% of total billed charges,62.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,82,
GALANTAMINE TAB  [4 MG],3500368,CDM,250,RC,J3490,HCPCS,outpatient,,,21,10.5,,13.65,65,,,percent of total billed charges,65% of total billed charges,14.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.65,65,,,percent of total billed charges,65% of total billed charges,13.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,53.67,
GAS INTUB LAVAG,3230941,CDM,450,RC,43753,HCPCS,outpatient,,,199,99.5,,129.35,65,,,percent of total billed charges,65% of total billed charges,135.32,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.8,20,,,percent of total billed charges,20% of total billed charges,39.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.8,20,,,percent of total billed charges,20% of total billed charges,39.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.35,65,,,percent of total billed charges,65% of total billed charges,129.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.8,178,
GASTROSTOMY 24 FR,3250649,CDM,272,RC,,,outpatient,,,127.35,63.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.47,20,,,percent of total billed charges,20% of total billed charges,25.47,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.47,20,,,percent of total billed charges,20% of total billed charges,25.47,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.78,65,,,percent of total billed charges,65% of total billed charges,82.78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.47,82.78,
GASTROSTOMY TUBE CHG,3020038,CDM,750,RC,43762,HCPCS,outpatient,,,201,100.5,,130.65,65,,,percent of total billed charges,65% of total billed charges,136.68,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,20,,,percent of total billed charges,20% of total billed charges,40.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,20,,,percent of total billed charges,20% of total billed charges,40.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.65,65,,,percent of total billed charges,65% of total billed charges,130.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,312,
GASTROSTOMY TUBE CHG,3230931,CDM,450,RC,43762,HCPCS,outpatient,,,201,100.5,,130.65,65,,,percent of total billed charges,65% of total billed charges,136.68,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,20,,,percent of total billed charges,20% of total billed charges,40.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,20,,,percent of total billed charges,20% of total billed charges,40.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.65,65,,,percent of total billed charges,65% of total billed charges,130.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,312,
GASTROVIEW/BOTTLE,3420001,CDM,250,RC,,,outpatient,,,74,37,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.8,20,,,percent of total billed charges,20% of total billed charges,14.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.8,20,,,percent of total billed charges,20% of total billed charges,14.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.1,65,,,percent of total billed charges,65% of total billed charges,48.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.8,53.67,
GAUZE HEMOSTATIC WOUND CLOT 4X4,3250310,CDM,272,RC,,,outpatient,,,76.6,38.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.32,20,,,percent of total billed charges,20% of total billed charges,15.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.32,20,,,percent of total billed charges,20% of total billed charges,15.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.79,65,,,percent of total billed charges,65% of total billed charges,49.79,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.32,53.67,
GAUZE PAD 4X4 GEN-USE,3250415,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
GAUZE PAD ST4X4 10PK,3250401,CDM,272,RC,,,outpatient,,,6.6,3.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.32,20,,,percent of total billed charges,20% of total billed charges,1.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.32,20,,,percent of total billed charges,20% of total billed charges,1.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.29,65,,,percent of total billed charges,65% of total billed charges,4.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.32,53.67,
GAUZE SPONGE 2X2 ST,3250411,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
GC  CULTURE E,3300689,CDM,306,RC,87070,HCPCS,outpatient,,,70,35,,45.5,65,,,percent of total billed charges,65% of total billed charges,47.6,68,,,percent of total billed charges,68% of total billed charges,12.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,65,,,percent of total billed charges,65% of total billed charges,45.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.22,47.6,
GEMFIBROZIL TAB [600 MG],3500369,CDM,250,RC,J3490,HCPCS,outpatient,,,21.15,10.58,,13.75,65,,,percent of total billed charges,65% of total billed charges,14.38,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.23,20,,,percent of total billed charges,20% of total billed charges,4.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.23,20,,,percent of total billed charges,20% of total billed charges,4.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.75,65,,,percent of total billed charges,65% of total billed charges,13.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.23,53.67,
GENERAL HEALTH PANEL,3300471,CDM,301,RC,80050,HCPCS,outpatient,,,189,94.5,,122.85,65,,,percent of total billed charges,65% of total billed charges,128.52,68,,,percent of total billed charges,68% of total billed charges,50.13,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,20,,,percent of total billed charges,20% of total billed charges,37.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,20,,,percent of total billed charges,20% of total billed charges,37.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.85,65,,,percent of total billed charges,65% of total billed charges,122.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,113.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,128.52,
GENTAMICIN 0.1% CRM,3500371,CDM,250,RC,J3490,HCPCS,outpatient,,,32.95,16.48,,21.42,65,,,percent of total billed charges,65% of total billed charges,22.41,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.59,20,,,percent of total billed charges,20% of total billed charges,6.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.59,20,,,percent of total billed charges,20% of total billed charges,6.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.42,65,,,percent of total billed charges,65% of total billed charges,21.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,53.67,
GENTAMICIN 0.3% EYE DRP,3500373,CDM,250,RC,J3490,HCPCS,outpatient,,,85.7,42.85,,55.71,65,,,percent of total billed charges,65% of total billed charges,58.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.14,20,,,percent of total billed charges,20% of total billed charges,17.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.14,20,,,percent of total billed charges,20% of total billed charges,17.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.71,65,,,percent of total billed charges,65% of total billed charges,55.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.14,58.28,
GENTAMICIN 0.3% EYE OINT,3500374,CDM,250,RC,J3490,HCPCS,outpatient,,,70.9,35.45,,46.09,65,,,percent of total billed charges,65% of total billed charges,48.21,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.18,20,,,percent of total billed charges,20% of total billed charges,14.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.18,20,,,percent of total billed charges,20% of total billed charges,14.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.09,65,,,percent of total billed charges,65% of total billed charges,46.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.18,53.67,
GENTAMICIN INJ [40 MG/ML],3500375,CDM,636,RC,J1580,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
GENTAMYCIN,3300189,CDM,301,RC,80170,HCPCS,outpatient,,,73,36.5,,47.45,65,,,percent of total billed charges,65% of total billed charges,49.64,68,,,percent of total billed charges,68% of total billed charges,23.26,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.6,20,,,percent of total billed charges,20% of total billed charges,14.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.6,20,,,percent of total billed charges,20% of total billed charges,14.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.45,65,,,percent of total billed charges,65% of total billed charges,47.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.6,49.64,
GGTP,3300141,CDM,301,RC,82977,HCPCS,outpatient,,,26,13,,16.9,65,,,percent of total billed charges,65% of total billed charges,17.68,68,,,percent of total billed charges,68% of total billed charges,10.21,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,20,,,percent of total billed charges,20% of total billed charges,5.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,20,,,percent of total billed charges,20% of total billed charges,5.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.9,65,,,percent of total billed charges,65% of total billed charges,16.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.2,17.68,
GI COCKTAIL,3500954,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GI DILATATION,3060253,CDM,750,RC,43249,HCPCS,outpatient,,,1210,605,,786.5,65,,,percent of total billed charges,65% of total billed charges,822.8,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,242,20,,,percent of total billed charges,20% of total billed charges,242,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,242,20,,,percent of total billed charges,20% of total billed charges,242,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,786.5,65,,,percent of total billed charges,65% of total billed charges,786.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,726,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,822.8,
GI WITH SMALL BOWEL,3400060,CDM,320,RC,74249,HCPCS,outpatient,,,495,247.5,,321.75,65,,,percent of total billed charges,65% of total billed charges,336.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,20,,,percent of total billed charges,20% of total billed charges,99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99,20,,,percent of total billed charges,20% of total billed charges,99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,321.75,65,,,percent of total billed charges,65% of total billed charges,321.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,297,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,336.6,
GI WITH SMALL BOWEL,3440091,CDM,972,RC,74249,HCPCS,outpatient,,,192.5,96.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,176.4,100,,,case rate,100% of case rate fee,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,176.4,
GIARDIA LAMBLIA ANT. TEST,3300718,CDM,306,RC,87329,HCPCS,outpatient,,,69,34.5,,44.85,65,,,percent of total billed charges,65% of total billed charges,46.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,20,,,percent of total billed charges,20% of total billed charges,13.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,20,,,percent of total billed charges,20% of total billed charges,13.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.85,65,,,percent of total billed charges,65% of total billed charges,44.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,46.92,
GLIMEPIRIDE TAB [1 MG],3500378,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GLIMEPIRIDE TAB [2 MG],3500379,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GLIMEPIRIDE TAB [4 MG],3500380,CDM,250,RC,J3490,HCPCS,outpatient,,,6.1,3.05,,3.97,65,,,percent of total billed charges,65% of total billed charges,4.15,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.22,20,,,percent of total billed charges,20% of total billed charges,1.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.22,20,,,percent of total billed charges,20% of total billed charges,1.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.97,65,,,percent of total billed charges,65% of total billed charges,3.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.22,53.67,
GLIPIZIDE ER TAB [2.5 MG],3500382,CDM,250,RC,J3490,HCPCS,outpatient,,,6.8,3.4,,4.42,65,,,percent of total billed charges,65% of total billed charges,4.62,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.36,20,,,percent of total billed charges,20% of total billed charges,1.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.36,20,,,percent of total billed charges,20% of total billed charges,1.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.42,65,,,percent of total billed charges,65% of total billed charges,4.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.36,53.67,
GLIPIZIDE ER TAB [5 MG],3500950,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GLIPIZIDE TAB [5 MG],3500384,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GLOVES SURGEON 6.5,3250457,CDM,272,RC,,,outpatient,,,9.47,4.74,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,20,,,percent of total billed charges,20% of total billed charges,1.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,20,,,percent of total billed charges,20% of total billed charges,1.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.16,65,,,percent of total billed charges,65% of total billed charges,6.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.89,53.67,
GLOVES SURGEON 7,3250453,CDM,272,RC,,,outpatient,,,9.5,4.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.9,20,,,percent of total billed charges,20% of total billed charges,1.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.9,20,,,percent of total billed charges,20% of total billed charges,1.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.18,65,,,percent of total billed charges,65% of total billed charges,6.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.9,53.67,
GLOVES SURGEON 7.5,3250455,CDM,272,RC,,,outpatient,,,9.47,4.74,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,20,,,percent of total billed charges,20% of total billed charges,1.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,20,,,percent of total billed charges,20% of total billed charges,1.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.16,65,,,percent of total billed charges,65% of total billed charges,6.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.89,53.67,
GLOVES SURGEON 8,3250545,CDM,272,RC,,,outpatient,,,9.47,4.74,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,20,,,percent of total billed charges,20% of total billed charges,1.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,20,,,percent of total billed charges,20% of total billed charges,1.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.16,65,,,percent of total billed charges,65% of total billed charges,6.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.89,53.67,
GLOVES SURGEON 8.5,3250454,CDM,272,RC,,,outpatient,,,9.5,4.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.9,20,,,percent of total billed charges,20% of total billed charges,1.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.9,20,,,percent of total billed charges,20% of total billed charges,1.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.18,65,,,percent of total billed charges,65% of total billed charges,6.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.9,53.67,
GLUCAGEN INJ [1 MG],3500969,CDM,636,RC,J1610,HCPCS,outpatient,,,617.8,308.9,,401.57,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,420.1,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.56,20,,,percent of total billed charges,20% of total billed charges,123.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.56,20,,,percent of total billed charges,20% of total billed charges,123.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,494.24,80,,,case rate,80% for high cost drug carve out,525.13,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,370.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123.56,525.13,
GLUCOSE BODY FLUID,3300383,CDM,301,RC,82945,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,30.6,
GLUCOSE OR FBS,3300053,CDM,301,RC,82947,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,5.57,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
GLUCOSE POST-DOSE,3300051,CDM,301,RC,82950,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,5.69,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.69,27.2,
GLUCOSE; BLOOD REAG STRIP,3300861,CDM,301,RC,82948,HCPCS,outpatient,,,10,5,,6.5,65,,,percent of total billed charges,65% of total billed charges,6.8,68,,,percent of total billed charges,68% of total billed charges,4.49,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.5,65,,,percent of total billed charges,65% of total billed charges,6.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2,6.8,
GLUT AC DCARB 65 ANTIBODY,3300786,CDM,309,RC,83519,HCPCS,outpatient,,,142.5,71.25,,92.63,65,,,percent of total billed charges,65% of total billed charges,96.9,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,20,,,percent of total billed charges,20% of total billed charges,28.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,20,,,percent of total billed charges,20% of total billed charges,28.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.63,65,,,percent of total billed charges,65% of total billed charges,92.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,96.9,
GLYBURIDE TAB [2.5 MG],3500386,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GLYBURIDE TAB [5 MG],3500387,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GLYCERIN SUPP ADULT,3500388,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
GLYCERIN SUPP CHILD,3500389,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
GLYCOMARK,3300463,CDM,301,RC,84378,HCPCS,outpatient,,,130,65,,84.5,65,,,percent of total billed charges,65% of total billed charges,88.4,68,,,percent of total billed charges,68% of total billed charges,11.05,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,20,,,percent of total billed charges,20% of total billed charges,26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,20,,,percent of total billed charges,20% of total billed charges,26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.5,65,,,percent of total billed charges,65% of total billed charges,84.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.05,88.4,
GLYCOPYRROLATE 0.2MG/ML,3510435,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
GOLD PROBE,3060055,CDM,272,RC,,,outpatient,,,580,290,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,116,20,,,percent of total billed charges,20% of total billed charges,116,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,116,20,,,percent of total billed charges,20% of total billed charges,116,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,377,65,,,percent of total billed charges,65% of total billed charges,377,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,348,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,377,
GRADUATED CONT 28 OZ,3250141,CDM,271,RC,,,outpatient,,,4,2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.8,20,,,percent of total billed charges,20% of total billed charges,0.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.8,20,,,percent of total billed charges,20% of total billed charges,0.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.6,65,,,percent of total billed charges,65% of total billed charges,2.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.8,53.67,
GRAM STAIN (SMEAR),3300709,CDM,306,RC,87205,HCPCS,outpatient,,,30,15,,19.5,65,,,percent of total billed charges,65% of total billed charges,20.4,68,,,percent of total billed charges,68% of total billed charges,6.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,20.4,
GROSS & MICRO EXAM LVL 3,3300807,CDM,310,RC,88304,HCPCS,outpatient,,,127,63.5,,82.55,65,,,percent of total billed charges,65% of total billed charges,86.36,68,,,percent of total billed charges,68% of total billed charges,17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.4,20,,,percent of total billed charges,20% of total billed charges,25.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.4,20,,,percent of total billed charges,20% of total billed charges,25.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.55,65,,,percent of total billed charges,65% of total billed charges,82.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17,86.36,
GROSS EXAM LEV2,3300821,CDM,310,RC,88302,HCPCS,outpatient,,,97,48.5,,63.05,65,,,percent of total billed charges,65% of total billed charges,65.96,68,,,percent of total billed charges,68% of total billed charges,14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.05,65,,,percent of total billed charges,65% of total billed charges,63.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,65.96,
GROSS EXAM ONLY,3300815,CDM,310,RC,88300,HCPCS,outpatient,,,69,34.5,,44.85,65,,,percent of total billed charges,65% of total billed charges,46.92,68,,,percent of total billed charges,68% of total billed charges,10,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,20,,,percent of total billed charges,20% of total billed charges,13.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,20,,,percent of total billed charges,20% of total billed charges,13.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.85,65,,,percent of total billed charges,65% of total billed charges,44.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,46.92,
GROSS&MICRO EXAM BIOP L 4,3300811,CDM,310,RC,88305,HCPCS,outpatient,,,226.6,113.3,,147.29,65,,,percent of total billed charges,65% of total billed charges,154.09,68,,,percent of total billed charges,68% of total billed charges,89,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.32,20,,,percent of total billed charges,20% of total billed charges,45.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.32,20,,,percent of total billed charges,20% of total billed charges,45.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147.29,65,,,percent of total billed charges,65% of total billed charges,147.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.3,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.32,154.09,
GROWTH HORMONE HUMAN,3300863,CDM,301,RC,83003,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,23.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,23.66,
GTT 1 HOUR,3300881,CDM,301,RC,82951,HCPCS,outpatient,,,41,20.5,,26.65,65,,,percent of total billed charges,65% of total billed charges,27.88,68,,,percent of total billed charges,68% of total billed charges,16.01,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.65,65,,,percent of total billed charges,65% of total billed charges,26.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.2,27.88,
GTT 2 HOUR,3300055,CDM,301,RC,82951,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,16.01,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,40.8,
GTT ADDITIONAL HOURS,3300057,CDM,301,RC,82952,HCPCS,outpatient,,,20,10,,13,65,,,percent of total billed charges,65% of total billed charges,13.6,68,,,percent of total billed charges,68% of total billed charges,4.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,13.6,
GUAIFEN/ DM LIQ [100-10 M,3500391,CDM,250,RC,J3490,HCPCS,outpatient,,,13.85,6.93,,9,65,,,percent of total billed charges,65% of total billed charges,9.42,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.77,20,,,percent of total billed charges,20% of total billed charges,2.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.77,20,,,percent of total billed charges,20% of total billed charges,2.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,65,,,percent of total billed charges,65% of total billed charges,9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.77,53.67,
GUAIFENESIN LIQ 100 MG/5M,3500392,CDM,250,RC,J3490,HCPCS,outpatient,,,4.65,2.33,,3.02,65,,,percent of total billed charges,65% of total billed charges,3.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.93,20,,,percent of total billed charges,20% of total billed charges,0.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.93,20,,,percent of total billed charges,20% of total billed charges,0.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.02,65,,,percent of total billed charges,65% of total billed charges,3.02,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.93,53.67,
GUAIFENESIN LIQ 100 MG/5M,3500393,CDM,250,RC,J3490,HCPCS,outpatient,,,4.4,2.2,,2.86,65,,,percent of total billed charges,65% of total billed charges,2.99,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.88,20,,,percent of total billed charges,20% of total billed charges,0.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.88,20,,,percent of total billed charges,20% of total billed charges,0.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.86,65,,,percent of total billed charges,65% of total billed charges,2.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.88,53.67,
GUAIFENESIN SYR [100 MG/5,3500394,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
GUAIFENESIN TAB [600 MG],3500395,CDM,250,RC,J3490,HCPCS,outpatient,,,5.05,2.53,,3.28,65,,,percent of total billed charges,65% of total billed charges,3.43,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.01,20,,,percent of total billed charges,20% of total billed charges,1.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.01,20,,,percent of total billed charges,20% of total billed charges,1.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.28,65,,,percent of total billed charges,65% of total billed charges,3.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.01,53.67,
H PYLORI AB,3300547,CDM,302,RC,86677,HCPCS,outpatient,,,49.5,24.75,,32.18,65,,,percent of total billed charges,65% of total billed charges,33.66,68,,,percent of total billed charges,68% of total billed charges,20.6,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.9,20,,,percent of total billed charges,20% of total billed charges,9.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.9,20,,,percent of total billed charges,20% of total billed charges,9.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.18,65,,,percent of total billed charges,65% of total billed charges,32.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,33.66,
"H PYLORI, UREA BREATH TEST",3300012,CDM,301,RC,83013,HCPCS,outpatient,,,176,88,,114.4,65,,,percent of total billed charges,65% of total billed charges,119.68,68,,,percent of total billed charges,68% of total billed charges,88.8,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.2,20,,,percent of total billed charges,20% of total billed charges,35.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.2,20,,,percent of total billed charges,20% of total billed charges,35.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.4,65,,,percent of total billed charges,65% of total billed charges,114.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,119.68,
H.PLORI IGG QUANT,3300519,CDM,302,RC,86677,HCPCS,outpatient,,,126,63,,81.9,65,,,percent of total billed charges,65% of total billed charges,85.68,68,,,percent of total billed charges,68% of total billed charges,20.6,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.2,20,,,percent of total billed charges,20% of total billed charges,25.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.2,20,,,percent of total billed charges,20% of total billed charges,25.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.9,65,,,percent of total billed charges,65% of total billed charges,81.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.6,85.68,
H.PYLORI AG (STOOL),3300765,CDM,306,RC,87338,HCPCS,outpatient,,,92,46,,59.8,65,,,percent of total billed charges,65% of total billed charges,62.56,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,65,,,percent of total billed charges,65% of total billed charges,59.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.4,62.56,
H/F DISP CIRCUIT,4000063,CDM,270,RC,,,outpatient,,,477.7,238.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.54,20,,,percent of total billed charges,20% of total billed charges,95.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.54,20,,,percent of total billed charges,20% of total billed charges,95.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,310.51,65,,,percent of total billed charges,65% of total billed charges,310.51,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,286.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,310.51,
HALDOL ASSAY,3300385,CDM,301,RC,80173,HCPCS,outpatient,,,54,27,,35.1,65,,,percent of total billed charges,65% of total billed charges,36.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.1,65,,,percent of total billed charges,65% of total billed charges,35.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,36.72,
HALOPERIDOL INJ [5 MG/ML],3500397,CDM,636,RC,J1630,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
HALOPERIDOL LIQ [2 MG/ML,3500398,CDM,250,RC,J3490,HCPCS,outpatient,,,8.9,4.45,,5.79,65,,,percent of total billed charges,65% of total billed charges,6.05,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.78,20,,,percent of total billed charges,20% of total billed charges,1.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.78,20,,,percent of total billed charges,20% of total billed charges,1.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.79,65,,,percent of total billed charges,65% of total billed charges,5.79,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.78,53.67,
HALOPERIDOL TAB (1MG),3500399,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HALOPERIDOL TAB [5 MG],3501023,CDM,250,RC,J3490,HCPCS,outpatient,,,5.15,2.58,,3.35,65,,,percent of total billed charges,65% of total billed charges,3.5,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.03,20,,,percent of total billed charges,20% of total billed charges,1.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.03,20,,,percent of total billed charges,20% of total billed charges,1.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.35,65,,,percent of total billed charges,65% of total billed charges,3.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.03,53.67,
HAND BIL 2 VIEW,3440409,CDM,972,RC,73120,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.67,110,,,fee schedule,110% of Medicare physician fee schedule,33.67,110,,,fee schedule,110% of Medicare physician fee schedule,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.6,115,,,fee schedule,115% of Medicare physician fee schedule,66.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.36,211.6,
HAND BIL MIN 2 VIEW,3400121,CDM,320,RC,73120,HCPCS,outpatient,,,212,106,,137.8,65,,,percent of total billed charges,65% of total billed charges,144.16,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.8,65,,,percent of total billed charges,65% of total billed charges,137.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
HAND BIL MIN 3 V,3440093,CDM,972,RC,73130,HCPCS,outpatient,,,82.5,41.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,217.85,115,,,fee schedule,115% of Medicare physician fee schedule,69.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,217.85,
HAND LT MIN 2 VIEW,3400122,CDM,320,RC,73120,HCPCS,outpatient,,,153,76.5,,99.45,65,,,percent of total billed charges,65% of total billed charges,104.04,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.45,65,,,percent of total billed charges,65% of total billed charges,99.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
HAND LT MIN 2 VIEW,3440411,CDM,972,RC,73120,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.67,110,,,fee schedule,110% of Medicare physician fee schedule,33.67,110,,,fee schedule,110% of Medicare physician fee schedule,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.6,115,,,fee schedule,115% of Medicare physician fee schedule,66.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.36,211.6,
HAND LT MIN 3 V,3440095,CDM,972,RC,73130,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,217.85,115,,,fee schedule,115% of Medicare physician fee schedule,69.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,217.85,
HAND RT MIN 2 VIEW,3400123,CDM,320,RC,73120,HCPCS,outpatient,,,153,76.5,,99.45,65,,,percent of total billed charges,65% of total billed charges,104.04,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,20,,,percent of total billed charges,20% of total billed charges,30.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.45,65,,,percent of total billed charges,65% of total billed charges,99.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
HAND RT MIN 2 VIEW,3440413,CDM,972,RC,73120,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.67,110,,,fee schedule,110% of Medicare physician fee schedule,33.67,110,,,fee schedule,110% of Medicare physician fee schedule,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.6,115,,,fee schedule,115% of Medicare physician fee schedule,66.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,38.72,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.36,211.6,
HAND RT MIN 3 V,3440097,CDM,972,RC,73130,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,39.64,110,,,fee schedule,110% of Medicare physician fee schedule,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,217.85,115,,,fee schedule,115% of Medicare physician fee schedule,69.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.59,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,217.85,
HAND-BIL MIN 3 VIEW,3400081,CDM,320,RC,73130,HCPCS,outpatient,,,228,114,,148.2,65,,,percent of total billed charges,65% of total billed charges,155.04,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.2,65,,,percent of total billed charges,65% of total billed charges,148.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
HAND-LT MIN 3 VIEW,3400003,CDM,320,RC,73130,HCPCS,outpatient,,,126.5,63.25,,82.23,65,,,percent of total billed charges,65% of total billed charges,86.02,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.23,65,,,percent of total billed charges,65% of total billed charges,82.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
HAND-RT MIN 3 VIEW,3400080,CDM,320,RC,73130,HCPCS,outpatient,,,126.5,63.25,,82.23,65,,,percent of total billed charges,65% of total billed charges,86.02,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.23,65,,,percent of total billed charges,65% of total billed charges,82.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
HAPTOGLOBIN,3300297,CDM,301,RC,83010,HCPCS,outpatient,,,57,28.5,,37.05,65,,,percent of total billed charges,65% of total billed charges,38.76,68,,,percent of total billed charges,68% of total billed charges,17.85,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,38.76,
HCG QUALITATIVE SERU,3300777,CDM,301,RC,84703,HCPCS,outpatient,,,41,20.5,,26.65,65,,,percent of total billed charges,65% of total billed charges,27.88,68,,,percent of total billed charges,68% of total billed charges,10.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.65,65,,,percent of total billed charges,65% of total billed charges,26.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.2,27.88,
HEAVY METALS SCREEN,3300105,CDM,301,RC,83015,HCPCS,outpatient,,,234,117,,152.1,65,,,percent of total billed charges,65% of total billed charges,159.12,68,,,percent of total billed charges,68% of total billed charges,26.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,20,,,percent of total billed charges,20% of total billed charges,46.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,20,,,percent of total billed charges,20% of total billed charges,46.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.1,65,,,percent of total billed charges,65% of total billed charges,152.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,140.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,159.12,
HEEL BIL MIN 2 V,3440099,CDM,972,RC,73650,HCPCS,outpatient,,,77,38.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.87,110,,,fee schedule,110% of Medicare physician fee schedule,30.87,110,,,fee schedule,110% of Medicare physician fee schedule,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.67,115,,,fee schedule,115% of Medicare physician fee schedule,67.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.75,208.67,
HEEL LT MIN 2 V,3440101,CDM,972,RC,73650,HCPCS,outpatient,,,45.1,22.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.87,110,,,fee schedule,110% of Medicare physician fee schedule,30.87,110,,,fee schedule,110% of Medicare physician fee schedule,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.67,115,,,fee schedule,115% of Medicare physician fee schedule,67.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.75,208.67,
HEEL-BIL MIN 2 VIEW,3400083,CDM,320,RC,73650,HCPCS,outpatient,,,156,78,,101.4,65,,,percent of total billed charges,65% of total billed charges,106.08,68,,,percent of total billed charges,68% of total billed charges,15.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,20,,,percent of total billed charges,20% of total billed charges,31.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,20,,,percent of total billed charges,20% of total billed charges,31.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,65,,,percent of total billed charges,65% of total billed charges,101.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,180,
HEEL-LT MIN 2 VIEW,3400028,CDM,320,RC,73650,HCPCS,outpatient,,,138.6,69.3,,90.09,65,,,percent of total billed charges,65% of total billed charges,94.25,68,,,percent of total billed charges,68% of total billed charges,15.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,20,,,percent of total billed charges,20% of total billed charges,27.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,20,,,percent of total billed charges,20% of total billed charges,27.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.09,65,,,percent of total billed charges,65% of total billed charges,90.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,180,
HEEL-R MIN 2 V,3440103,CDM,972,RC,73650,HCPCS,outpatient,,,45.1,22.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.87,110,,,fee schedule,110% of Medicare physician fee schedule,30.87,110,,,fee schedule,110% of Medicare physician fee schedule,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.67,115,,,fee schedule,115% of Medicare physician fee schedule,67.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.5,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.75,208.67,
HEEL-RT MIN 2 VIEW,3400082,CDM,320,RC,73650,HCPCS,outpatient,,,138.6,69.3,,90.09,65,,,percent of total billed charges,65% of total billed charges,94.25,68,,,percent of total billed charges,68% of total billed charges,15.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,20,,,percent of total billed charges,20% of total billed charges,27.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.72,20,,,percent of total billed charges,20% of total billed charges,27.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.09,65,,,percent of total billed charges,65% of total billed charges,90.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,180,
HEEL/ELBOW PROTECTOR,3250193,CDM,271,RC,,,outpatient,,,55.35,27.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.07,20,,,percent of total billed charges,20% of total billed charges,11.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.07,20,,,percent of total billed charges,20% of total billed charges,11.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.98,65,,,percent of total billed charges,65% of total billed charges,35.98,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,53.67,
HEMATOCRIT,3300683,CDM,305,RC,85014,HCPCS,outpatient,,,15,7.5,,9.75,65,,,percent of total billed charges,65% of total billed charges,10.2,68,,,percent of total billed charges,68% of total billed charges,3.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,10.2,
HEMATURIA 3-WAY FOLEY,3250602,CDM,272,RC,,,outpatient,,,304.5,152.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.9,20,,,percent of total billed charges,20% of total billed charges,60.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.9,20,,,percent of total billed charges,20% of total billed charges,60.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,197.93,65,,,percent of total billed charges,65% of total billed charges,197.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,197.93,
HEMOGLOBIN,3300681,CDM,305,RC,85018,HCPCS,outpatient,,,15,7.5,,9.75,65,,,percent of total billed charges,65% of total billed charges,10.2,68,,,percent of total billed charges,68% of total billed charges,3.35,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,10.2,
Hemoglobinopathy Evaluation,3300941,CDM,300,RC,83020,HCPCS,outpatient,,,75.4,37.7,,49.01,65,,,percent of total billed charges,65% of total billed charges,51.27,68,,,percent of total billed charges,68% of total billed charges,18.28,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.08,20,,,percent of total billed charges,20% of total billed charges,15.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.08,20,,,percent of total billed charges,20% of total billed charges,15.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.01,65,,,percent of total billed charges,65% of total billed charges,49.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.7,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.08,51.27,
HEMORRHOIDECTOMY INT EXT 2/> GROUP,3462014,CDM,982,RC,46260,HCPCS,outpatient,,,665,332.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,345.29,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,547.18,110,,,fee schedule,110% of Medicare physician fee schedule,547.18,110,,,fee schedule,110% of Medicare physician fee schedule,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,572.06,115,,,fee schedule,115% of Medicare physician fee schedule,397.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,345.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,629.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,345.29,629.26,
HEMORRHOIDECTOMY INTERNAL 1 GROUP,3462013,CDM,982,RC,46255,HCPCS,outpatient,,,698,349,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,245.98,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,402.29,110,,,fee schedule,110% of Medicare physician fee schedule,402.29,110,,,fee schedule,110% of Medicare physician fee schedule,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,420.58,115,,,fee schedule,115% of Medicare physician fee schedule,298.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,245.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,462.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,245.98,462.64,
HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,3462079,CDM,982,RC,46250,HCPCS,outpatient,,,637,318.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,219.99,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,360.23,110,,,fee schedule,110% of Medicare physician fee schedule,360.23,110,,,fee schedule,110% of Medicare physician fee schedule,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,376.6,115,,,fee schedule,115% of Medicare physician fee schedule,272.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,414.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,219.99,414.26,
HEP A AB IGG & IGM,3300557,CDM,302,RC,86708,HCPCS,outpatient,,,71,35.5,,46.15,65,,,percent of total billed charges,65% of total billed charges,48.28,68,,,percent of total billed charges,68% of total billed charges,17.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.15,65,,,percent of total billed charges,65% of total billed charges,46.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,48.28,
HEP A AB TOTAL,3300559,CDM,302,RC,86708,HCPCS,outpatient,,,71,35.5,,46.15,65,,,percent of total billed charges,65% of total billed charges,48.28,68,,,percent of total billed charges,68% of total billed charges,17.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.15,65,,,percent of total billed charges,65% of total billed charges,46.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,48.28,
HEP A IGM AB,3300555,CDM,302,RC,86709,HCPCS,outpatient,,,79,39.5,,51.35,65,,,percent of total billed charges,65% of total billed charges,53.72,68,,,percent of total billed charges,68% of total billed charges,15.55,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.8,20,,,percent of total billed charges,20% of total billed charges,15.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.8,20,,,percent of total billed charges,20% of total billed charges,15.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.35,65,,,percent of total billed charges,65% of total billed charges,51.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.55,53.72,
HEP B CORE ANTIBODY,3300567,CDM,302,RC,86704,HCPCS,outpatient,,,57,28.5,,37.05,65,,,percent of total billed charges,65% of total billed charges,38.76,68,,,percent of total billed charges,68% of total billed charges,16.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,38.76,
HEP B CORE IGM AB,3300561,CDM,302,RC,86705,HCPCS,outpatient,,,83,41.5,,53.95,65,,,percent of total billed charges,65% of total billed charges,56.44,68,,,percent of total billed charges,68% of total billed charges,16.27,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.95,65,,,percent of total billed charges,65% of total billed charges,53.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.27,56.44,
HEP B SUR ANTIBODY,3300569,CDM,302,RC,86706,HCPCS,outpatient,,,57,28.5,,37.05,65,,,percent of total billed charges,65% of total billed charges,38.76,68,,,percent of total billed charges,68% of total billed charges,14.84,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,38.76,
HEP B SURFACE AB QL,3300553,CDM,302,RC,86706,HCPCS,outpatient,,,63,31.5,,40.95,65,,,percent of total billed charges,65% of total billed charges,42.84,68,,,percent of total billed charges,68% of total billed charges,14.84,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.95,65,,,percent of total billed charges,65% of total billed charges,40.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,42.84,
HEP B SURFACE ANTIGE,3300729,CDM,306,RC,87340,HCPCS,outpatient,,,57,28.5,,37.05,65,,,percent of total billed charges,65% of total billed charges,38.76,68,,,percent of total billed charges,68% of total billed charges,14.27,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,38.76,
HEP BE ANTIBODY,3300565,CDM,302,RC,86707,HCPCS,outpatient,,,57,28.5,,37.05,65,,,percent of total billed charges,65% of total billed charges,38.76,68,,,percent of total billed charges,68% of total billed charges,15.98,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,38.76,
HEP BE ANTIGEN,3300731,CDM,306,RC,87350,HCPCS,outpatient,,,57,28.5,,37.05,65,,,percent of total billed charges,65% of total billed charges,38.76,68,,,percent of total billed charges,68% of total billed charges,15.92,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,38.76,
HEP C AB,3300563,CDM,302,RC,86803,HCPCS,outpatient,,,91,45.5,,59.15,65,,,percent of total billed charges,65% of total billed charges,61.88,68,,,percent of total billed charges,68% of total billed charges,19.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.2,20,,,percent of total billed charges,20% of total billed charges,18.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.2,20,,,percent of total billed charges,20% of total billed charges,18.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.15,65,,,percent of total billed charges,65% of total billed charges,59.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.2,61.88,
"HEPARIN INJ [5,000 UNT/ML",3500403,CDM,636,RC,J1644,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
HEPARIN LOCK FLUSH INJ [3,3500404,CDM,636,RC,J1642,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
HEPARIN/ 0.45% NS INJ PRE,3500405,CDM,636,RC,J1644,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
HEPARIN/ 0.45% NS INJ PRE,3500405,CDM,636,RC,J1644,HCPCS,outpatient,,,52,26,,,,,,other,Not reimbursable per contract ,35.36,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.6,80,,,case rate,80% for high cost drug carve out,44.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.4,44.2,
HEPATIC FUN PANEL,3300151,CDM,301,RC,80076,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,11.29,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.29,51,
HEPATITIS B S AG,3300727,CDM,306,RC,87340,HCPCS,outpatient,,,73,36.5,,47.45,65,,,percent of total billed charges,65% of total billed charges,49.64,68,,,percent of total billed charges,68% of total billed charges,14.27,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.6,20,,,percent of total billed charges,20% of total billed charges,14.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.6,20,,,percent of total billed charges,20% of total billed charges,14.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.45,65,,,percent of total billed charges,65% of total billed charges,47.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.27,49.64,
HEPATITIS PANEL ACUT,3300157,CDM,301,RC,80074,HCPCS,outpatient,,,218,109,,141.7,65,,,percent of total billed charges,65% of total billed charges,148.24,68,,,percent of total billed charges,68% of total billed charges,65.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.6,20,,,percent of total billed charges,20% of total billed charges,43.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.6,20,,,percent of total billed charges,20% of total billed charges,43.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.7,65,,,percent of total billed charges,65% of total billed charges,141.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.6,148.24,
HGB A1C,3300159,CDM,301,RC,83036,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,13.78,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.78,51,
HGB ELECTROPHORESIS,3300013,CDM,301,RC,83020,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,18.28,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
HIAA 5,3300139,CDM,301,RC,83497,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,18.3,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,51,
HIP BIL MIN 2 V,3440105,CDM,972,RC,73521,HCPCS,outpatient,,,128.7,64.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.69,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.32,110,,,fee schedule,110% of Medicare physician fee schedule,44.32,110,,,fee schedule,110% of Medicare physician fee schedule,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.73,115,,,fee schedule,115% of Medicare physician fee schedule,73.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.69,222.73,
HIP BIL MIN 2 VIEW,3400029,CDM,320,RC,73521,HCPCS,outpatient,,,220,110,,143,65,,,percent of total billed charges,65% of total billed charges,149.6,68,,,percent of total billed charges,68% of total billed charges,22.37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.37,180,
HIP LT MIN 2 V,3440107,CDM,972,RC,73502,HCPCS,outpatient,,,70.4,35.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.27,110,,,fee schedule,110% of Medicare physician fee schedule,50.27,110,,,fee schedule,110% of Medicare physician fee schedule,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,228.96,115,,,fee schedule,115% of Medicare physician fee schedule,75.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.71,228.96,
HIP RT MIN 2 V,3440109,CDM,972,RC,73502,HCPCS,outpatient,,,70.4,35.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.27,110,,,fee schedule,110% of Medicare physician fee schedule,50.27,110,,,fee schedule,110% of Medicare physician fee schedule,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,228.96,115,,,fee schedule,115% of Medicare physician fee schedule,75.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.71,228.96,
HIP-LT MIN 2 VIEW,3400004,CDM,320,RC,73502,HCPCS,outpatient,,,195,97.5,,126.75,65,,,percent of total billed charges,65% of total billed charges,132.6,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.75,65,,,percent of total billed charges,65% of total billed charges,126.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
HIP-RT MIN 2 VIEW,3400084,CDM,320,RC,73502,HCPCS,outpatient,,,195,97.5,,126.75,65,,,percent of total billed charges,65% of total billed charges,132.6,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.75,65,,,percent of total billed charges,65% of total billed charges,126.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
HISTOPLASMA AB CF,3300595,CDM,302,RC,86698,HCPCS,outpatient,,,94,47,,61.1,65,,,percent of total billed charges,65% of total billed charges,63.92,68,,,percent of total billed charges,68% of total billed charges,17.75,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.1,65,,,percent of total billed charges,65% of total billed charges,61.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.75,63.92,
HIV AB,3300497,CDM,302,RC,86701,HCPCS,outpatient,,,71,35.5,,46.15,65,,,percent of total billed charges,65% of total billed charges,48.28,68,,,percent of total billed charges,68% of total billed charges,12.61,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.15,65,,,percent of total billed charges,65% of total billed charges,46.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.61,48.28,
HIV-1 GENOTYPE,3300753,CDM,306,RC,87901,HCPCS,outpatient,,,375,187.5,,243.75,65,,,percent of total billed charges,65% of total billed charges,255,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,20,,,percent of total billed charges,20% of total billed charges,75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,20,,,percent of total billed charges,20% of total billed charges,75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,243.75,65,,,percent of total billed charges,65% of total billed charges,243.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,187.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,255,
HIV-1 QUANT,3300755,CDM,306,RC,87536,HCPCS,outpatient,,,375,187.5,,243.75,65,,,percent of total billed charges,65% of total billed charges,255,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,20,,,percent of total billed charges,20% of total billed charges,75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,20,,,percent of total billed charges,20% of total billed charges,75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,243.75,65,,,percent of total billed charges,65% of total billed charges,243.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,187.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,225,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,255,
HIV-1 RNA,3300733,CDM,306,RC,87536,HCPCS,outpatient,,,260,130,,169,65,,,percent of total billed charges,65% of total billed charges,176.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,20,,,percent of total billed charges,20% of total billed charges,52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,20,,,percent of total billed charges,20% of total billed charges,52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,169,65,,,percent of total billed charges,65% of total billed charges,169,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52,176.8,
HOT BIOPSY FORCEP,3060181,CDM,272,RC,,,outpatient,,,137,68.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.4,20,,,percent of total billed charges,20% of total billed charges,27.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.4,20,,,percent of total billed charges,20% of total billed charges,27.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.05,65,,,percent of total billed charges,65% of total billed charges,89.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.4,89.05,
HSV I IGM ANTIBODY,3300549,CDM,302,RC,86695,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,18.72,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,51,
HSV II IGM ANTIBODY,3300617,CDM,302,RC,86696,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,51,
HUMERUS BIL 2 V,3440111,CDM,972,RC,73060,HCPCS,outpatient,,,79,39.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.69,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,212.69,
HUMERUS LT MIN 2 V,3440113,CDM,972,RC,73060,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.69,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,212.69,
HUMERUS MIN 2 VW BIL,3400086,CDM,320,RC,73060,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
HUMERUS MIN 2 VW LT,3400030,CDM,320,RC,73060,HCPCS,outpatient,,,184.8,92.4,,120.12,65,,,percent of total billed charges,65% of total billed charges,125.66,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.96,20,,,percent of total billed charges,20% of total billed charges,36.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.96,20,,,percent of total billed charges,20% of total billed charges,36.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.12,65,,,percent of total billed charges,65% of total billed charges,120.12,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
HUMERUS MIN 2 VW RT,3400085,CDM,320,RC,73060,HCPCS,outpatient,,,184.8,92.4,,120.12,65,,,percent of total billed charges,65% of total billed charges,125.66,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.96,20,,,percent of total billed charges,20% of total billed charges,36.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.96,20,,,percent of total billed charges,20% of total billed charges,36.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.12,65,,,percent of total billed charges,65% of total billed charges,120.12,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,110.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
HUMERUS RT MIN 2 V,3440115,CDM,972,RC,73060,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,34.72,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.69,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.92,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,212.69,
"HUMIDIFIER, HI-LO",4000054,CDM,270,RC,,,outpatient,,,89.5,44.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.9,20,,,percent of total billed charges,20% of total billed charges,17.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.9,20,,,percent of total billed charges,20% of total billed charges,17.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.18,65,,,percent of total billed charges,65% of total billed charges,58.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.9,58.18,
HYDRALAZINE INJ [20 MG/ML,3500406,CDM,636,RC,J0360,HCPCS,outpatient,,,50.65,25.33,,,,,,other,Not reimbursable per contract ,34.44,68,,,case rate,68% of high cost drug carve out,9.75,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.13,20,,,percent of total billed charges,20% of total billed charges,10.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.13,20,,,percent of total billed charges,20% of total billed charges,10.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.52,80,,,case rate,80% for high cost drug carve out,43.05,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.75,43.05,
HYDRALAZINE TAB [10 MG],3500407,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDRALAZINE TAB [25 MG],3500408,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDRALAZINE TAB [50 MG],3500409,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROCHLOROTHIAZIDE CAP [,3500410,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROCHLOROTHIAZIDE TAB [,3500411,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROCHLOROTHIAZIDE TAB [,3500412,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROCO BIT 5 MG/HOMAT ME,3500898,CDM,250,RC,J3490,HCPCS,outpatient,,,18.75,9.38,,12.19,65,,,percent of total billed charges,65% of total billed charges,12.75,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.75,20,,,percent of total billed charges,20% of total billed charges,3.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.75,20,,,percent of total billed charges,20% of total billed charges,3.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.19,65,,,percent of total billed charges,65% of total billed charges,12.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.75,53.67,
HYDROCOD/ ACET TAB [10-32,3500414,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
HYDROCOD/ ACET TAB [5-325,3500415,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
HYDROCOD/ ACET TAB [7.5-3,3500416,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
HYDROCODONE/ACETAMINOPHEN 7.5-325 MG/15,3521949,CDM,250,RC,,,outpatient,,,42.3,21.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.46,20,,,percent of total billed charges,20% of total billed charges,8.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.46,20,,,percent of total billed charges,20% of total billed charges,8.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,65,,,percent of total billed charges,65% of total billed charges,27.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.46,53.67,
HYDROCORTCOSTROID 17,3300127,CDM,301,RC,83491,HCPCS,outpatient,,,102,51,,66.3,65,,,percent of total billed charges,65% of total billed charges,69.36,68,,,percent of total billed charges,68% of total billed charges,24.86,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,20,,,percent of total billed charges,20% of total billed charges,20.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,20,,,percent of total billed charges,20% of total billed charges,20.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.3,65,,,percent of total billed charges,65% of total billed charges,66.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,69.36,
HYDROCORTISONE 0.5% CRM,3500419,CDM,250,RC,J3490,HCPCS,outpatient,,,14.4,7.2,,9.36,65,,,percent of total billed charges,65% of total billed charges,9.79,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.88,20,,,percent of total billed charges,20% of total billed charges,2.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.88,20,,,percent of total billed charges,20% of total billed charges,2.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.36,65,,,percent of total billed charges,65% of total billed charges,9.36,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.88,53.67,
HYDROCORTISONE 1% CRM,3500420,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROCORTISONE 2.5%  CRM,3500421,CDM,250,RC,J3490,HCPCS,outpatient,,,22,11,,14.3,65,,,percent of total billed charges,65% of total billed charges,14.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.3,65,,,percent of total billed charges,65% of total billed charges,14.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,53.67,
HYDROCORTISONE INJ [100 M,3500422,CDM,636,RC,J1720,HCPCS,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,10.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.8,80,,,case rate,80% for high cost drug carve out,13.6,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.2,13.6,
HYDROCORTISONE INJ [250 M,3500423,CDM,636,RC,J1720,HCPCS,outpatient,,,146.7,73.35,,,,,,other,Not reimbursable per contract ,99.76,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.34,20,,,percent of total billed charges,20% of total billed charges,29.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.34,20,,,percent of total billed charges,20% of total billed charges,29.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117.36,80,,,case rate,80% for high cost drug carve out,124.7,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.34,124.7,
HYDROCORTISONE SUPP [25 M,3500424,CDM,250,RC,J3490,HCPCS,outpatient,,,19.7,9.85,,12.81,65,,,percent of total billed charges,65% of total billed charges,13.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.94,20,,,percent of total billed charges,20% of total billed charges,3.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.94,20,,,percent of total billed charges,20% of total billed charges,3.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.81,65,,,percent of total billed charges,65% of total billed charges,12.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.94,53.67,
HYDROCORTISONE TAB [10 MG,3500425,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROFERA BLUE 6X6,3521942,CDM,272,RC,,,outpatient,,,120.12,60.06,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.02,20,,,percent of total billed charges,20% of total billed charges,24.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.02,20,,,percent of total billed charges,20% of total billed charges,24.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.08,65,,,percent of total billed charges,65% of total billed charges,78.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.02,78.08,
HYDROGEL AG GEL [4 OZ],3500986,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROGEN PEROXIDE 3% SOL,3500426,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROMORPHNE 0.5MG/0.5ML PF SYR,3501146,CDM,636,RC,J1170,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
HYDROMORPHONE [2 MG],3501012,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
HYDROMORPHONE INJ [1MG/ML,3500429,CDM,636,RC,J1170,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
HYDROMORPHONE SYR [2 MG/M,3500430,CDM,636,RC,J1170,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
HYDROXYCHLOROQUINE TAB [2,3500431,CDM,250,RC,J3490,HCPCS,outpatient,,,11.75,5.88,,7.64,65,,,percent of total billed charges,65% of total billed charges,7.99,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.35,20,,,percent of total billed charges,20% of total billed charges,2.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.35,20,,,percent of total billed charges,20% of total billed charges,2.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.64,65,,,percent of total billed charges,65% of total billed charges,7.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.35,53.67,
HYDROXYUREA CAP [500 MG],3500979,CDM,250,RC,J3490,HCPCS,outpatient,,,5.55,2.78,,3.61,65,,,percent of total billed charges,65% of total billed charges,3.77,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.11,20,,,percent of total billed charges,20% of total billed charges,1.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.11,20,,,percent of total billed charges,20% of total billed charges,1.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.61,65,,,percent of total billed charges,65% of total billed charges,3.61,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.11,53.67,
HYDROXYZINE HCL TAB [10 M,3500433,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROXYZINE HCL TAB [25 M,3500434,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROXYZINE INJ [50 MG/ML,3500435,CDM,636,RC,J3410,HCPCS,outpatient,,,108.9,54.45,,,,,,other,Not reimbursable per contract ,74.05,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.78,20,,,percent of total billed charges,20% of total billed charges,21.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.78,20,,,percent of total billed charges,20% of total billed charges,21.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.12,80,,,case rate,80% for high cost drug carve out,92.57,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.78,92.57,
HYDROXYZINE PAM CAP [25 M,3500437,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYDROXYZINE PAM CAP [50 M,3500438,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYOSCYAMINE CAP [0.375 MG,3500439,CDM,250,RC,J3490,HCPCS,outpatient,,,24.5,12.25,,15.93,65,,,percent of total billed charges,65% of total billed charges,16.66,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.9,20,,,percent of total billed charges,20% of total billed charges,4.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.9,20,,,percent of total billed charges,20% of total billed charges,4.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.93,65,,,percent of total billed charges,65% of total billed charges,15.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.9,53.67,
HYOSCYAMINE DRP (0.125 MG,3500884,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYOSCYAMINE SULF DRP [0.1,3500981,CDM,250,RC,J3490,HCPCS,outpatient,,,14,7,,9.1,65,,,percent of total billed charges,65% of total billed charges,9.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.1,65,,,percent of total billed charges,65% of total billed charges,9.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,53.67,
HYOSCYAMINE TAB [0.125 MG,3500440,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
HYTRIN 2 MG,3521877,CDM,250,RC,,,outpatient,,,5.65,2.83,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.13,20,,,percent of total billed charges,20% of total billed charges,1.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.13,20,,,percent of total billed charges,20% of total billed charges,1.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.67,65,,,percent of total billed charges,65% of total billed charges,3.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.13,53.67,
I & D ABSCESS COMP/MULTI PF,3700290,CDM,983,RC,10061,HCPCS,outpatient,,,655,327.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.29,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,202.85,110,,,fee schedule,110% of Medicare physician fee schedule,202.85,110,,,fee schedule,110% of Medicare physician fee schedule,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.07,115,,,fee schedule,115% of Medicare physician fee schedule,176.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.29,233.28,
I & D ABSCESS COMPLEX MULTI,3700289,CDM,510,RC,10061,HCPCS,outpatient,,,575,287.5,,373.75,65,,,percent of total billed charges,65% of total billed charges,391,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115,20,,,percent of total billed charges,20% of total billed charges,115,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115,20,,,percent of total billed charges,20% of total billed charges,115,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,373.75,65,,,percent of total billed charges,65% of total billed charges,373.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,345,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,391,
I & D ABSCESS COMPLEX MULTIPLE,3060420,CDM,361,RC,10061,HCPCS,outpatient,,,1510,755,,981.5,65,,,percent of total billed charges,65% of total billed charges,1026.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302,20,,,percent of total billed charges,20% of total billed charges,302,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302,20,,,percent of total billed charges,20% of total billed charges,302,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,981.5,65,,,percent of total billed charges,65% of total billed charges,981.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,906,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1026.8,
I & D ABSCESS COMPLICATED/MULTIPLE,3462043,CDM,982,RC,10061,HCPCS,outpatient,,,754,377,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.29,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,202.85,110,,,fee schedule,110% of Medicare physician fee schedule,202.85,110,,,fee schedule,110% of Medicare physician fee schedule,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.07,115,,,fee schedule,115% of Medicare physician fee schedule,176.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,233.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.29,233.28,
I & D DRAINAGE ABSCESS SIMPLE PRO/CLINIC,3700072,CDM,983,RC,10060,HCPCS,outpatient,,,314,157,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.7,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,115.03,110,,,fee schedule,110% of Medicare physician fee schedule,115.03,110,,,fee schedule,110% of Medicare physician fee schedule,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,120.26,115,,,fee schedule,115% of Medicare physician fee schedule,121.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.7,132.28,
I & D DRAINGE ABSCESS SIMPLE PRO/OP,3700074,CDM,982,RC,10060,HCPCS,outpatient,,,157,78.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.7,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,115.03,110,,,fee schedule,110% of Medicare physician fee schedule,115.03,110,,,fee schedule,110% of Medicare physician fee schedule,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,120.26,115,,,fee schedule,115% of Medicare physician fee schedule,121.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.7,132.28,
I & D HEMATOMA FLUID PRO FEE,3700292,CDM,983,RC,10140,HCPCS,outpatient,,,390,195,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.06,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,130.33,110,,,fee schedule,110% of Medicare physician fee schedule,130.33,110,,,fee schedule,110% of Medicare physician fee schedule,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,136.25,115,,,fee schedule,115% of Medicare physician fee schedule,132.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,80.06,149.88,
I & D HEMATOMA SEROMA/FLUID COLLECTION,3462048,CDM,982,RC,10140,HCPCS,outpatient,,,607,303.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.06,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,130.33,110,,,fee schedule,110% of Medicare physician fee schedule,130.33,110,,,fee schedule,110% of Medicare physician fee schedule,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,136.25,115,,,fee schedule,115% of Medicare physician fee schedule,132.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,80.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,149.88,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,80.06,149.88,
I & D HEMATOMA SEROMA/FLUID COLLECTION,3700291,CDM,510,RC,10140,HCPCS,outpatient,,,500,250,,325,65,,,percent of total billed charges,65% of total billed charges,340,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,20,,,percent of total billed charges,20% of total billed charges,100,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,20,,,percent of total billed charges,20% of total billed charges,100,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,325,65,,,percent of total billed charges,65% of total billed charges,325,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,665,
I & D OF VULVA OR PERINEAL ABSCE PRO FEE,3462112,CDM,982,RC,56405,HCPCS,outpatient,,,256,128,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.29,110,,,fee schedule,110% of Medicare physician fee schedule,142.29,110,,,fee schedule,110% of Medicare physician fee schedule,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.75,115,,,fee schedule,115% of Medicare physician fee schedule,134.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,82.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,163.63,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,82.1,163.63,
I & D OF VULVA OR PERINEAL ABSCESS,3060417,CDM,360,RC,56405,HCPCS,outpatient,,,420,210,,273,65,,,percent of total billed charges,65% of total billed charges,285.6,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84,20,,,percent of total billed charges,20% of total billed charges,84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84,20,,,percent of total billed charges,20% of total billed charges,84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,273,65,,,percent of total billed charges,65% of total billed charges,273,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,252,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,419,
I & D PILONIDAL CYST SIMPLE,3462044,CDM,982,RC,10080,HCPCS,outpatient,,,275,137.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.62,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,115.67,110,,,fee schedule,110% of Medicare physician fee schedule,115.67,110,,,fee schedule,110% of Medicare physician fee schedule,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,120.92,115,,,fee schedule,115% of Medicare physician fee schedule,123.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.62,133.01,
I & D PILONIDAL CYST/COMPLICATED,3462045,CDM,982,RC,10081,HCPCS,outpatient,,,402,201,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,116.53,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,192.67,110,,,fee schedule,110% of Medicare physician fee schedule,192.67,110,,,fee schedule,110% of Medicare physician fee schedule,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,201.42,115,,,fee schedule,115% of Medicare physician fee schedule,169.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,116.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.56,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,116.53,221.56,
I O NEEDLE PLACEMENT,3231163,CDM,450,RC,36680,HCPCS,outpatient,,,780,390,,507,65,,,percent of total billed charges,65% of total billed charges,530.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156,20,,,percent of total billed charges,20% of total billed charges,156,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156,20,,,percent of total billed charges,20% of total billed charges,156,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,507,65,,,percent of total billed charges,65% of total billed charges,507,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,530.4,
I&D,3020023,CDM,360,RC,10060,HCPCS,outpatient,,,280,140,,182,65,,,percent of total billed charges,65% of total billed charges,190.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,65,,,percent of total billed charges,65% of total billed charges,182,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,190.4,
I&D ABCESS COMPL,3231077,CDM,450,RC,10061,HCPCS,outpatient,,,268,134,,174.2,65,,,percent of total billed charges,65% of total billed charges,182.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.6,20,,,percent of total billed charges,20% of total billed charges,53.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.6,20,,,percent of total billed charges,20% of total billed charges,53.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.2,65,,,percent of total billed charges,65% of total billed charges,174.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.6,182.24,
I&D ABCESS SIMPLE,3231075,CDM,450,RC,10060,HCPCS,outpatient,,,139,69.5,,90.35,65,,,percent of total billed charges,65% of total billed charges,94.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.8,20,,,percent of total billed charges,20% of total billed charges,27.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.35,65,,,percent of total billed charges,65% of total billed charges,90.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.8,178,
I&D ASPIR OF ABCESS,3231081,CDM,450,RC,10060,HCPCS,outpatient,,,131,65.5,,85.15,65,,,percent of total billed charges,65% of total billed charges,89.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.2,20,,,percent of total billed charges,20% of total billed charges,26.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.2,20,,,percent of total billed charges,20% of total billed charges,26.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.15,65,,,percent of total billed charges,65% of total billed charges,85.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.2,178,
I&D EXT THROM HEMO,3231083,CDM,450,RC,,,outpatient,,,228,114,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,20,,,percent of total billed charges,20% of total billed charges,45.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.2,65,,,percent of total billed charges,65% of total billed charges,148.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.8,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,148.2,
I&D/EXC SKIN LESION,3231085,CDM,450,RC,,,outpatient,,,262,131,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.4,20,,,percent of total billed charges,20% of total billed charges,52.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.4,20,,,percent of total billed charges,20% of total billed charges,52.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.3,65,,,percent of total billed charges,65% of total billed charges,170.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.7,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.4,170.3,
IA2 AUTOANTIBODIES,3300790,CDM,309,RC,86341,HCPCS,outpatient,,,117,58.5,,76.05,65,,,percent of total billed charges,65% of total billed charges,79.56,68,,,percent of total billed charges,68% of total billed charges,28.08,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.4,20,,,percent of total billed charges,20% of total billed charges,23.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.4,20,,,percent of total billed charges,20% of total billed charges,23.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.05,65,,,percent of total billed charges,65% of total billed charges,76.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.4,79.56,
IBUPROFEN LIQ [200 MG/10,3500441,CDM,250,RC,J3490,HCPCS,outpatient,,,7.25,3.63,,4.71,65,,,percent of total billed charges,65% of total billed charges,4.93,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.45,20,,,percent of total billed charges,20% of total billed charges,1.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.45,20,,,percent of total billed charges,20% of total billed charges,1.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.71,65,,,percent of total billed charges,65% of total billed charges,4.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.45,53.67,
IBUPROFEN SUSP 100MG/5ML,3501120,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
IBUPROFEN TAB [200 MG],3500442,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
IBUPROFEN TAB [400 MG],3500443,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
IBUPROFEN TAB [600 MG],3500444,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
IBUPROFEN TAB [800 MG],3500445,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
IF-DEX 5 NACL 1/4,3521901,CDM,258,RC,,,outpatient,,,60,30,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IF-DEX 5 PF/ADV 100,3521865,CDM,258,RC,,,outpatient,,,49,24.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.8,20,,,percent of total billed charges,20% of total billed charges,9.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.8,20,,,percent of total billed charges,20% of total billed charges,9.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.85,65,,,percent of total billed charges,65% of total billed charges,31.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,53.67,
IGE,3300253,CDM,301,RC,82785,HCPCS,outpatient,,,76,38,,49.4,65,,,percent of total billed charges,65% of total billed charges,51.68,68,,,percent of total billed charges,68% of total billed charges,23.38,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.2,20,,,percent of total billed charges,20% of total billed charges,15.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.2,20,,,percent of total billed charges,20% of total billed charges,15.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.4,65,,,percent of total billed charges,65% of total billed charges,49.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.2,51.68,
IGG/IGA/IGM GAMM,3300251,CDM,301,RC,82784,HCPCS,outpatient,,,58,29,,37.7,65,,,percent of total billed charges,65% of total billed charges,39.44,68,,,percent of total billed charges,68% of total billed charges,13.2,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.6,20,,,percent of total billed charges,20% of total billed charges,11.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.6,20,,,percent of total billed charges,20% of total billed charges,11.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.7,65,,,percent of total billed charges,65% of total billed charges,37.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.6,39.44,
IM/SQ INJECTION-OR,3060306,CDM,260,RC,96372,HCPCS,outpatient,,,48,24,,31.2,65,,,percent of total billed charges,65% of total billed charges,32.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,20,,,percent of total billed charges,20% of total billed charges,9.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,20,,,percent of total billed charges,20% of total billed charges,9.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,65,,,percent of total billed charges,65% of total billed charges,31.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,53.67,
IMIPENEM/CILAS INJ [250 M,3500446,CDM,636,RC,J0743,HCPCS,outpatient,,,26.95,13.48,,,,,,other,Not reimbursable per contract ,18.33,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.39,20,,,percent of total billed charges,20% of total billed charges,5.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.39,20,,,percent of total billed charges,20% of total billed charges,5.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.56,80,,,case rate,80% for high cost drug carve out,22.91,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.39,22.91,
IMIPENEM/CILAS INJ [500 M,3500447,CDM,636,RC,J0743,HCPCS,outpatient,,,176.35,88.18,,,,,,other,Not reimbursable per contract ,119.92,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.27,20,,,percent of total billed charges,20% of total billed charges,35.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.27,20,,,percent of total billed charges,20% of total billed charges,35.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.08,80,,,case rate,80% for high cost drug carve out,149.9,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.27,149.9,
IMMOBILIZER HEAD-ADULT,3250667,CDM,270,RC,,,outpatient,,,34.26,17.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.85,20,,,percent of total billed charges,20% of total billed charges,6.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.85,20,,,percent of total billed charges,20% of total billed charges,6.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.27,65,,,percent of total billed charges,65% of total billed charges,22.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.85,53.67,
IMMOBILIZER HEAD-CHILD,3250592,CDM,270,RC,,,outpatient,,,14.9,7.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.98,20,,,percent of total billed charges,20% of total billed charges,2.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.98,20,,,percent of total billed charges,20% of total billed charges,2.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.69,65,,,percent of total billed charges,65% of total billed charges,9.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.98,53.67,
IMMOBILIZER HEAD-PEDIATRIC,3250668,CDM,274,RC,,,both,,,34.26,17.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.85,20,,,percent of total billed charges,20% of total billed charges,6.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.85,20,,,percent of total billed charges,20% of total billed charges,6.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.41,80,,,case rate,80% for implant carve out,29.12,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.85,29.12,
IMMOBILIZER KN SMALL,3250287,CDM,274,RC,L1830,HCPCS,both,,,350,175,,227.5,65,,,percent of total billed charges,65% of total billed charges,238,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70,20,,,percent of total billed charges,20% of total billed charges,70,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70,20,,,percent of total billed charges,20% of total billed charges,70,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,280,80,,,case rate,80% for implant carve out,297.5,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70,297.5,
IMMOBILIZER KNE XLAR,3250291,CDM,274,RC,L1830,HCPCS,both,,,253.35,126.68,,164.68,65,,,percent of total billed charges,65% of total billed charges,172.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.67,20,,,percent of total billed charges,20% of total billed charges,50.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.67,20,,,percent of total billed charges,20% of total billed charges,50.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,202.68,80,,,case rate,80% for implant carve out,215.35,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.67,215.35,
IMMOBILIZER KNEE LARGE,3250290,CDM,274,RC,L1830,HCPCS,both,,,253.35,126.68,,164.68,65,,,percent of total billed charges,65% of total billed charges,172.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.67,20,,,percent of total billed charges,20% of total billed charges,50.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.67,20,,,percent of total billed charges,20% of total billed charges,50.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,202.68,80,,,case rate,80% for implant carve out,215.35,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.67,215.35,
IMMOBILIZER KNEE MED,3250289,CDM,274,RC,L1830,HCPCS,both,,,282,141,,183.3,65,,,percent of total billed charges,65% of total billed charges,191.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,20,,,percent of total billed charges,20% of total billed charges,56.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,20,,,percent of total billed charges,20% of total billed charges,56.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,225.6,80,,,case rate,80% for implant carve out,239.7,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,239.7,
IMMOBILIZER SHLD LAR,3250283,CDM,274,RC,L3675,HCPCS,both,,,47.3,23.65,,30.75,65,,,percent of total billed charges,65% of total billed charges,32.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.46,20,,,percent of total billed charges,20% of total billed charges,9.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.46,20,,,percent of total billed charges,20% of total billed charges,9.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.84,80,,,case rate,80% for implant carve out,40.21,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.46,40.21,
IMMOBILIZER SHLD MED,3250281,CDM,274,RC,L3675,HCPCS,both,,,52.25,26.13,,33.96,65,,,percent of total billed charges,65% of total billed charges,35.53,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.45,20,,,percent of total billed charges,20% of total billed charges,10.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.45,20,,,percent of total billed charges,20% of total billed charges,10.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.8,80,,,case rate,80% for implant carve out,44.41,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.45,44.41,
IMMOBILIZER SHLD SMA,3250305,CDM,274,RC,L3675,HCPCS,both,,,28,14,,18.2,65,,,percent of total billed charges,65% of total billed charges,19.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.6,20,,,percent of total billed charges,20% of total billed charges,5.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.6,20,,,percent of total billed charges,20% of total billed charges,5.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,80,,,case rate,80% for implant carve out,23.8,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,23.8,
IMMOBILIZER SHOULDER,3250179,CDM,274,RC,L3675,HCPCS,both,,,72.2,36.1,,46.93,65,,,percent of total billed charges,65% of total billed charges,49.1,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.44,20,,,percent of total billed charges,20% of total billed charges,14.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.44,20,,,percent of total billed charges,20% of total billed charges,14.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.76,80,,,case rate,80% for implant carve out,61.37,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.44,61.37,
IMMUN ADMIN EA ADDITIONAL,3230938,CDM,771,RC,90472,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,85,
IMMUN ADMIN INITIAL,3230937,CDM,771,RC,90471,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,85,
IMMUNFIX E-PHOR/URINE/CSF,3300871,CDM,302,RC,86335,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,30.6,
IMMUNOCHEM EA AB,3300829,CDM,310,RC,88342,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,129.2,
IMMUNOCYTOCHEM AB,3300833,CDM,310,RC,88342,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,129.2,
IMMUOGLOBULINS,3300107,CDM,301,RC,82787,HCPCS,outpatient,,,156,78,,101.4,65,,,percent of total billed charges,65% of total billed charges,106.08,68,,,percent of total billed charges,68% of total billed charges,17.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,20,,,percent of total billed charges,20% of total billed charges,31.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,20,,,percent of total billed charges,20% of total billed charges,31.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.4,65,,,percent of total billed charges,65% of total billed charges,101.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.22,106.08,
IMPLANT MESH OPEN HERNIA RPR/DEBRIDE,3462074,CDM,982,RC,49568,HCPCS,outpatient,,,386,193,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,189.35,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,241.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,189.35,241.95,
INCENTIVE SPIROMETER,3170035,CDM,272,RC,,,outpatient,,,37,18.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.4,20,,,percent of total billed charges,20% of total billed charges,7.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.4,20,,,percent of total billed charges,20% of total billed charges,7.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.05,65,,,percent of total billed charges,65% of total billed charges,24.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.4,53.67,
INCISION REMOVAL FB SUBQ TISS COMPL,3462047,CDM,982,RC,10121,HCPCS,outpatient,,,363,181.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.84,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,205.03,110,,,fee schedule,110% of Medicare physician fee schedule,205.03,110,,,fee schedule,110% of Medicare physician fee schedule,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.35,115,,,fee schedule,115% of Medicare physician fee schedule,177.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.78,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.84,235.78,
INCISION REMOVAL FB SUBQ TISS SIMPLE,3462046,CDM,982,RC,10120,HCPCS,outpatient,,,200,100,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.15,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,115.98,110,,,fee schedule,110% of Medicare physician fee schedule,115.98,110,,,fee schedule,110% of Medicare physician fee schedule,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,121.26,115,,,fee schedule,115% of Medicare physician fee schedule,122.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,133.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.15,133.38,
INDOMETHACIN CAP [25 MG],3500449,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
INFANT CHILD AMBU,3170055,CDM,272,RC,,,outpatient,,,70.5,35.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.1,20,,,percent of total billed charges,20% of total billed charges,14.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.1,20,,,percent of total billed charges,20% of total billed charges,14.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.83,65,,,percent of total billed charges,65% of total billed charges,45.83,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,53.67,
INFLATABLE CUSHION RING,3250033,CDM,271,RC,,,outpatient,,,58.7,29.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.74,20,,,percent of total billed charges,20% of total billed charges,11.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.74,20,,,percent of total billed charges,20% of total billed charges,11.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.16,65,,,percent of total billed charges,65% of total billed charges,38.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.74,53.67,
INFLATION SYRINGE,3060193,CDM,272,RC,,,outpatient,,,320,160,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64,20,,,percent of total billed charges,20% of total billed charges,64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64,20,,,percent of total billed charges,20% of total billed charges,64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,208,65,,,percent of total billed charges,65% of total billed charges,208,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,208,
INFLUENZA A,3300914,CDM,300,RC,87804,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,27.2,
INFLUENZA AB (BLOOD),3300631,CDM,302,RC,86710,HCPCS,outpatient,,,50,25,,32.5,65,,,percent of total billed charges,65% of total billed charges,34,68,,,percent of total billed charges,68% of total billed charges,19.24,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,34,
INFLUENZA AB (SWAB),3300763,CDM,306,RC,87804,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,27.2,
INFLUENZA ADMIN-OBS,3040026,CDM,771,RC,G0008,HCPCS,outpatient,,,35,17.5,,22.75,65,,,percent of total billed charges,65% of total billed charges,23.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.75,65,,,percent of total billed charges,65% of total billed charges,22.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,85,
INFLUENZA B,3300915,CDM,300,RC,87804,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,27.2,
INITAL NURSING FACILITY CARE/DAY 25 MIN,3462102,CDM,982,RC,99304,HCPCS,outpatient,,,121,60.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,61.68,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,88.03,109,,,fee schedule,109% of Medicare physician fee schedule,176.86,109,,,fee schedule,109% of Medicare physician fee schedule,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.87,115,,,fee schedule,115% of Medicare physician fee schedule,114.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,102.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.68,176.86,
INITIAL HOSP CARE/DAY 50 MIN,3462092,CDM,982,RC,99222,HCPCS,outpatient,,,202,101,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.83,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.59,109,,,fee schedule,109% of Medicare physician fee schedule,288.49,109,,,fee schedule,109% of Medicare physician fee schedule,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,151.49,115,,,fee schedule,115% of Medicare physician fee schedule,146.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,93.83,288.49,
INITIAL HOSP CARE/DAY 70 MIN,3462093,CDM,982,RC,99223,HCPCS,outpatient,,,293,146.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,137.51,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,190.77,109,,,fee schedule,109% of Medicare physician fee schedule,383.29,109,,,fee schedule,109% of Medicare physician fee schedule,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,201.27,115,,,fee schedule,115% of Medicare physician fee schedule,190.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,221.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.51,383.29,
INITIAL HOSPITAL CARE/DAY 30 MIN,3462091,CDM,982,RC,99221,HCPCS,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,69.84,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.42,109,,,fee schedule,109% of Medicare physician fee schedule,185.69,109,,,fee schedule,109% of Medicare physician fee schedule,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,97.51,115,,,fee schedule,115% of Medicare physician fee schedule,122.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,69.84,185.69,
INITIAL NURSING FACILITY CARE/DAY 35 MIN,3462103,CDM,982,RC,99305,HCPCS,outpatient,,,172,86,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,89.03,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,145.73,109,,,fee schedule,109% of Medicare physician fee schedule,292.8,109,,,fee schedule,109% of Medicare physician fee schedule,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,153.76,115,,,fee schedule,115% of Medicare physician fee schedule,141.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,89.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,169.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,89.03,292.8,
INITIAL NURSING FACILITY CARE/DAY 45 MIN,3462104,CDM,982,RC,99306,HCPCS,outpatient,,,223,111.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,114.23,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,198.71,109,,,fee schedule,109% of Medicare physician fee schedule,399.24,109,,,fee schedule,109% of Medicare physician fee schedule,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.65,115,,,fee schedule,115% of Medicare physician fee schedule,166.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,230.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,114.23,399.24,
INJ/IV PSH NEW/SQ MED,3060006,CDM,260,RC,96375,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
INJ/IV PSH NEW/SQ MED-OBS,3040021,CDM,260,RC,96375,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
INJ/IV PUSH NEW/SEQ MED,3230963,CDM,450,RC,96375,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
INJ/IV PUSH SAME MED,3230965,CDM,450,RC,96376,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,50,,,percent of total billed charges,50% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
INJ/IV PUSH SAME MED-OBS,3040022,CDM,260,RC,96376,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
INJECTION IV PUSH-OBSERV,3040020,CDM,260,RC,96374,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,57.12,
INJECTION SC/IM,3230955,CDM,450,RC,96372,HCPCS,outpatient,,,48,24,,31.2,65,,,percent of total billed charges,65% of total billed charges,32.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,20,,,percent of total billed charges,20% of total billed charges,9.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,20,,,percent of total billed charges,20% of total billed charges,9.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,65,,,percent of total billed charges,65% of total billed charges,31.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,50,,,percent of total billed charges,50% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,53.67,
INJECTION SC/IM-OBSERV,3040019,CDM,260,RC,96372,HCPCS,outpatient,,,48,24,,31.2,65,,,percent of total billed charges,65% of total billed charges,32.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,20,,,percent of total billed charges,20% of total billed charges,9.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,20,,,percent of total billed charges,20% of total billed charges,9.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,65,,,percent of total billed charges,65% of total billed charges,31.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,53.67,
INJECTOR NEEDLES,3060131,CDM,272,RC,,,outpatient,,,313.6,156.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.72,20,,,percent of total billed charges,20% of total billed charges,62.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.72,20,,,percent of total billed charges,20% of total billed charges,62.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,203.84,65,,,percent of total billed charges,65% of total billed charges,203.84,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,188.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,203.84,
INLINE WATER TRAP,4000055,CDM,270,RC,,,outpatient,,,25.35,12.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,20,,,percent of total billed charges,20% of total billed charges,5.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,20,,,percent of total billed charges,20% of total billed charges,5.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.48,65,,,percent of total billed charges,65% of total billed charges,16.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,53.67,
INS PM PLS GEN W/EXIST SINGLE LEAD,3462087,CDM,982,RC,33212,HCPCS,outpatient,,,453,226.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,229.42,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,365.95,110,,,fee schedule,110% of Medicare physician fee schedule,365.95,110,,,fee schedule,110% of Medicare physician fee schedule,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,382.58,115,,,fee schedule,115% of Medicare physician fee schedule,282.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,420.84,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,229.42,420.84,
INS PM PULSE GEN ONLY W/EXIST DUAL LEADS,3462088,CDM,982,RC,33213,HCPCS,outpatient,,,474,237,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,239.26,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,382.92,110,,,fee schedule,110% of Medicare physician fee schedule,382.92,110,,,fee schedule,110% of Medicare physician fee schedule,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,400.33,115,,,fee schedule,115% of Medicare physician fee schedule,291.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.26,100,,,fee schedule,100% of FL Medicaid fee schedule ,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,440.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,239.26,440.36,
INS- ASPART INJ [DOSE],3500452,CDM,636,RC,J1815,HCPCS,outpatient,,,6.65,3.33,,,,,,other,Not reimbursable per contract ,4.52,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.33,20,,,percent of total billed charges,20% of total billed charges,1.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.33,20,,,percent of total billed charges,20% of total billed charges,1.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.32,80,,,case rate,80% for high cost drug carve out,5.65,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.33,5.65,
INS- LEVEMIR [100 UNT/ML,3500453,CDM,636,RC,J1815,HCPCS,outpatient,,,6.5,3.25,,,,,,other,Not reimbursable per contract ,4.42,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.3,20,,,percent of total billed charges,20% of total billed charges,1.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.3,20,,,percent of total billed charges,20% of total billed charges,1.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.2,80,,,case rate,80% for high cost drug carve out,5.53,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.3,5.53,
INS- NPH HUMAN INJ [100 U,3500454,CDM,636,RC,J1815,HCPCS,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,2.24,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.64,80,,,case rate,80% for high cost drug carve out,2.81,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,2.81,
INS- REG  HUMAN INJ [100,3500456,CDM,636,RC,J1815,HCPCS,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,2.24,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.64,80,,,case rate,80% for high cost drug carve out,2.81,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,2.81,
INS/DRAIN THROMBOSED HEMORRHOID,3060413,CDM,360,RC,46083,HCPCS,outpatient,,,755,377.5,,490.75,65,,,percent of total billed charges,65% of total billed charges,513.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,151,20,,,percent of total billed charges,20% of total billed charges,151,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,151,20,,,percent of total billed charges,20% of total billed charges,151,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,490.75,65,,,percent of total billed charges,65% of total billed charges,490.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,453,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,513.4,
INS/DRAIN THROMBOSED HEMORRHOID,3462109,CDM,982,RC,46083,HCPCS,outpatient,,,603,301.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.92,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.66,110,,,fee schedule,110% of Medicare physician fee schedule,123.66,110,,,fee schedule,110% of Medicare physician fee schedule,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,129.28,115,,,fee schedule,115% of Medicare physician fee schedule,127.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.92,142.21,
INS/DRAIN THROMBOSED HEMORRHOID,3700311,CDM,510,RC,46083,HCPCS,outpatient,,,402,201,,261.3,65,,,percent of total billed charges,65% of total billed charges,273.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.4,20,,,percent of total billed charges,20% of total billed charges,80.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.4,20,,,percent of total billed charges,20% of total billed charges,80.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261.3,65,,,percent of total billed charges,65% of total billed charges,261.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,241.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,273.36,
INS/DRAIN THROMBOSED HEMORRHOID,3700312,CDM,983,RC,46083,HCPCS,outpatient,,,350,175,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.92,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,123.66,110,,,fee schedule,110% of Medicare physician fee schedule,123.66,110,,,fee schedule,110% of Medicare physician fee schedule,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,129.28,115,,,fee schedule,115% of Medicare physician fee schedule,127.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,142.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.92,142.21,
INSERT INDWL TUNNLD PLEURAL CATH,3462086,CDM,982,RC,32550,HCPCS,outpatient,,,1025,512.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.28,110,,,fee schedule,110% of Medicare physician fee schedule,229.28,110,,,fee schedule,110% of Medicare physician fee schedule,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,239.71,115,,,fee schedule,115% of Medicare physician fee schedule,190.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,263.68,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,138.22,263.68,
INSERT NON-TUNNEL CV CATH,3700078,CDM,360,RC,36556,HCPCS,outpatient,,,1180.5,590.25,,767.33,65,,,percent of total billed charges,65% of total billed charges,802.74,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,236.1,20,,,percent of total billed charges,20% of total billed charges,236.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,236.1,20,,,percent of total billed charges,20% of total billed charges,236.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,767.33,65,,,percent of total billed charges,65% of total billed charges,767.33,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,708.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,802.74,
INSERT NON-TUNNEL CV PROFEE,3462002,CDM,982,RC,36556,HCPCS,outpatient,,,283,141.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,95,110,,,fee schedule,110% of Medicare physician fee schedule,95,110,,,fee schedule,110% of Medicare physician fee schedule,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.31,115,,,fee schedule,115% of Medicare physician fee schedule,109.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,57,100,,,fee schedule,100% of FL Medicaid fee schedule ,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.25,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57,109.6,
INSERT PICC 5YR+W/O IMAGING,3231127,CDM,450,RC,36569,HCPCS,outpatient,,,781,390.5,,507.65,65,,,percent of total billed charges,65% of total billed charges,531.08,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156.2,20,,,percent of total billed charges,20% of total billed charges,156.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156.2,20,,,percent of total billed charges,20% of total billed charges,156.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,507.65,65,,,percent of total billed charges,65% of total billed charges,507.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,468.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,531.08,
INSERTION OF CHEST TUBE,3462033,CDM,982,RC,32551,HCPCS,outpatient,,,223,111.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,110.63,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,177.36,110,,,fee schedule,110% of Medicare physician fee schedule,177.36,110,,,fee schedule,110% of Medicare physician fee schedule,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,185.43,115,,,fee schedule,115% of Medicare physician fee schedule,163.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,203.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.63,203.97,
INSUFFLATION TUBING,6215820,CDM,272,RC,,,outpatient,,,142.56,71.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.51,20,,,percent of total billed charges,20% of total billed charges,28.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.51,20,,,percent of total billed charges,20% of total billed charges,28.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.66,65,,,percent of total billed charges,65% of total billed charges,92.66,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.51,92.66,
INSULIN GLARGINE,3501263,CDM,637,RC,J1815,HCPCS,outpatient,,,2.4,1.2,,1.56,65,,,percent of total billed charges,65% of total billed charges,1.63,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.48,20,,,percent of total billed charges,20% of total billed charges,0.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.48,20,,,percent of total billed charges,20% of total billed charges,0.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.56,65,,,percent of total billed charges,65% of total billed charges,1.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.48,53.67,
INSULIN GROWTH FACTOR 1,3300920,CDM,301,RC,84305,HCPCS,outpatient,,,201,100.5,,130.65,65,,,percent of total billed charges,65% of total billed charges,136.68,68,,,percent of total billed charges,68% of total billed charges,27.25,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,20,,,percent of total billed charges,20% of total billed charges,40.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,20,,,percent of total billed charges,20% of total billed charges,40.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.65,65,,,percent of total billed charges,65% of total billed charges,130.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.25,136.68,
INSULIN LISPRO,3501262,CDM,637,RC,J1815,HCPCS,outpatient,,,6.6,3.3,,4.29,65,,,percent of total billed charges,65% of total billed charges,4.49,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.32,20,,,percent of total billed charges,20% of total billed charges,1.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.32,20,,,percent of total billed charges,20% of total billed charges,1.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.29,65,,,percent of total billed charges,65% of total billed charges,4.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.32,53.67,
INSULIN TOLERANCE,3300339,CDM,301,RC,83525,HCPCS,outpatient,,,195,97.5,,126.75,65,,,percent of total billed charges,65% of total billed charges,132.6,68,,,percent of total billed charges,68% of total billed charges,16.23,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.75,65,,,percent of total billed charges,65% of total billed charges,126.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.23,132.6,
INTERNAL HRHC LIG W/O IMG,3060421,CDM,361,RC,46945,HCPCS,outpatient,,,1100,550,,715,65,,,percent of total billed charges,65% of total billed charges,748,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,220,20,,,percent of total billed charges,20% of total billed charges,220,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,220,20,,,percent of total billed charges,20% of total billed charges,220,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,715,65,,,percent of total billed charges,65% of total billed charges,715,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1478,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,660,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1478,
INTERNAL HRHC LIG W/O IMG PRO FEE,3462115,CDM,982,RC,46945,HCPCS,outpatient,,,774,387,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,143.97,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,376.54,110,,,fee schedule,110% of Medicare physician fee schedule,376.54,110,,,fee schedule,110% of Medicare physician fee schedule,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,393.66,115,,,fee schedule,115% of Medicare physician fee schedule,196.57,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,143.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,433.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,143.97,433.02,
INTUBATION,3170089,CDM,450,RC,31500,HCPCS,outpatient,,,500,250,,325,65,,,percent of total billed charges,65% of total billed charges,340,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,20,,,percent of total billed charges,20% of total billed charges,100,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,20,,,percent of total billed charges,20% of total billed charges,100,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,325,65,,,percent of total billed charges,65% of total billed charges,325,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,340,
INTUBATION BLADES,3170113,CDM,272,RC,,,outpatient,,,46.04,23.02,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.21,20,,,percent of total billed charges,20% of total billed charges,9.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.21,20,,,percent of total billed charges,20% of total billed charges,9.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.93,65,,,percent of total billed charges,65% of total billed charges,29.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.21,53.67,
INTUBATION MED SURG,3170122,CDM,410,RC,,,outpatient,,,500,250,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,20,,,percent of total billed charges,20% of total billed charges,100,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,20,,,percent of total billed charges,20% of total billed charges,100,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,325,65,,,percent of total billed charges,65% of total billed charges,325,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,325,
INTUBATION STYLET,3170114,CDM,272,RC,,,outpatient,,,9.31,4.66,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.86,20,,,percent of total billed charges,20% of total billed charges,1.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.86,20,,,percent of total billed charges,20% of total billed charges,1.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.05,65,,,percent of total billed charges,65% of total billed charges,6.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.86,53.67,
INVEST TRANSFUS REACTION,3300873,CDM,302,RC,86078,HCPCS,outpatient,,,92,46,,59.8,65,,,percent of total billed charges,65% of total billed charges,62.56,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.4,20,,,percent of total billed charges,20% of total billed charges,18.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,65,,,percent of total billed charges,65% of total billed charges,59.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.4,62.56,
IOBAN 2,6215837,CDM,272,RC,,,outpatient,,,93.56,46.78,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.71,20,,,percent of total billed charges,20% of total billed charges,18.71,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.71,20,,,percent of total billed charges,20% of total billed charges,18.71,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.81,65,,,percent of total billed charges,65% of total billed charges,60.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.71,60.81,
IPRATROPIUM MDI,3500896,CDM,636,RC,J3535,HCPCS,outpatient,,,428.2,214.1,,,,,,other,Not reimbursable per contract ,291.18,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.64,20,,,percent of total billed charges,20% of total billed charges,85.64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.64,20,,,percent of total billed charges,20% of total billed charges,85.64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,342.56,80,,,case rate,80% for high cost drug carve out,363.97,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,256.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.64,363.97,
IRG SOL NACL 9 250,3250651,CDM,272,RC,,,outpatient,,,7.36,3.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.47,20,,,percent of total billed charges,20% of total billed charges,1.47,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.47,20,,,percent of total billed charges,20% of total billed charges,1.47,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.78,65,,,percent of total billed charges,65% of total billed charges,4.78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.47,53.67,
IRG SOL NACL9% 500ML,3250625,CDM,272,RC,,,outpatient,,,5.7,2.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.14,20,,,percent of total billed charges,20% of total billed charges,1.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.14,20,,,percent of total billed charges,20% of total billed charges,1.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.71,65,,,percent of total billed charges,65% of total billed charges,3.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.14,53.67,
IRG SOL ST H20 IM/2F7114,3250644,CDM,272,RC,,,outpatient,,,4.4,2.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.88,20,,,percent of total billed charges,20% of total billed charges,0.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.88,20,,,percent of total billed charges,20% of total billed charges,0.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.86,65,,,percent of total billed charges,65% of total billed charges,2.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.88,53.67,
IRON,3300109,CDM,301,RC,83540,HCPCS,outpatient,,,33,16.5,,21.45,65,,,percent of total billed charges,65% of total billed charges,22.44,68,,,percent of total billed charges,68% of total billed charges,9.2,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.6,20,,,percent of total billed charges,20% of total billed charges,6.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.6,20,,,percent of total billed charges,20% of total billed charges,6.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.45,65,,,percent of total billed charges,65% of total billed charges,21.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.6,22.44,
IRON BINDING CAPACTY,3300111,CDM,301,RC,83550,HCPCS,outpatient,,,47,23.5,,30.55,65,,,percent of total billed charges,65% of total billed charges,31.96,68,,,percent of total billed charges,68% of total billed charges,12.4,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.4,20,,,percent of total billed charges,20% of total billed charges,9.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.4,20,,,percent of total billed charges,20% of total billed charges,9.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.55,65,,,percent of total billed charges,65% of total billed charges,30.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.4,31.96,
IRREG BULB 60 ML,6215894,CDM,272,RC,,,outpatient,,,10.75,5.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,20,,,percent of total billed charges,20% of total billed charges,2.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,20,,,percent of total billed charges,20% of total billed charges,2.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.99,65,,,percent of total billed charges,65% of total billed charges,6.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.15,53.67,
IRRIG SOD CHL 3000ML 9%,3250568,CDM,272,RC,,,outpatient,,,43.9,21.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.78,20,,,percent of total billed charges,20% of total billed charges,8.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.78,20,,,percent of total billed charges,20% of total billed charges,8.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.54,65,,,percent of total billed charges,65% of total billed charges,28.54,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.78,53.67,
IRRIG TRAY W/PISTON,3250631,CDM,272,RC,,,outpatient,,,43,21.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.6,20,,,percent of total billed charges,20% of total billed charges,8.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.6,20,,,percent of total billed charges,20% of total billed charges,8.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.95,65,,,percent of total billed charges,65% of total billed charges,27.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.6,53.67,
ISO-VITAL SIGNS KIT,3250673,CDM,272,RC,,,outpatient,,,21.97,10.99,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.39,20,,,percent of total billed charges,20% of total billed charges,4.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.39,20,,,percent of total billed charges,20% of total billed charges,4.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.28,65,,,percent of total billed charges,65% of total billed charges,14.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.39,53.67,
ISO/EXA NOCLEICACID,3300373,CDM,301,RC,,,outpatient,,,50,25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.5,35,,,percent of total billed charges,35% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,32.5,
ISOLATION,3020013,CDM,160,RC,,,inpatient,,,787.5,393.75,,1750,100,,,per diem,"1750 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2600 for 2 days with a per diem after of 1000 or 3600 for 4 days with a per diem after of 1000. It can also pay at a er diem rate of 600, 1500 or 650 if non med/surg procedures are performed",1837,100,,,per diem,"1837 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2730 for 2 days with a per diem after of 1050 or 3780 for 4 days with a per diem after of 1050. It can also pay at a er diem rate of 630, 1575 or 683 if non med/surg procedures are performed",,,,,other,Not separately reimbursable for physician per contract terms,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,157.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,157.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,157.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,157.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,MS-DRG,,other,Pays at CMS DRG weights with UHC base rate markup. See MS-DRG rows. Can also pay at per diem rate of 1200 for rehab or SNF,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,157.5,1837,
ISOSORBIDE DN TAB [20 MG],3500468,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ISOSORBIDE MONO ER TAB [3,3500469,CDM,250,RC,J3490,HCPCS,outpatient,,,8.3,4.15,,5.4,65,,,percent of total billed charges,65% of total billed charges,5.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.66,20,,,percent of total billed charges,20% of total billed charges,1.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.66,20,,,percent of total billed charges,20% of total billed charges,1.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,65,,,percent of total billed charges,65% of total billed charges,5.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.66,53.67,
ISOSORBIDE MONO ER TAB [6,3500470,CDM,250,RC,J3490,HCPCS,outpatient,,,10,5,,6.5,65,,,percent of total billed charges,65% of total billed charges,6.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.5,65,,,percent of total billed charges,65% of total billed charges,6.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2,53.67,
ISOSORBIDE/HYDRAL TAB [20,3500471,CDM,250,RC,J3490,HCPCS,outpatient,,,21.4,10.7,,13.91,65,,,percent of total billed charges,65% of total billed charges,14.55,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.28,20,,,percent of total billed charges,20% of total billed charges,4.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.28,20,,,percent of total billed charges,20% of total billed charges,4.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.91,65,,,percent of total billed charges,65% of total billed charges,13.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.28,53.67,
IV 0.9 NACL 25 ML,3521921,CDM,258,RC,,,outpatient,,,52,26,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.4,53.67,
IV ARMBOARD PED,3250211,CDM,271,RC,,,outpatient,,,24.6,12.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.92,20,,,percent of total billed charges,20% of total billed charges,4.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.92,20,,,percent of total billed charges,20% of total billed charges,4.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.99,65,,,percent of total billed charges,65% of total billed charges,15.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.92,53.67,
IV DEX 5% 100 ML,3520292,CDM,258,RC,,,outpatient,,,12.55,6.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.51,20,,,percent of total billed charges,20% of total billed charges,2.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.51,20,,,percent of total billed charges,20% of total billed charges,2.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.16,65,,,percent of total billed charges,65% of total billed charges,8.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.51,53.67,
IV DEXTROSE 100ML,3521863,CDM,258,RC,,,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,53.67,
IV EXT W INJ 11958,3250577,CDM,272,RC,,,outpatient,,,42.4,21.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.48,20,,,percent of total billed charges,20% of total billed charges,8.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.48,20,,,percent of total billed charges,20% of total billed charges,8.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.56,65,,,percent of total billed charges,65% of total billed charges,27.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.48,53.67,
IV INF/CONCURRENT,3230953,CDM,260,RC,96368,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IV INF/CONCURRENT-OBSERV,3040018,CDM,260,RC,96368,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IV INF/HYDRAT 1ST HR,3230943,CDM,260,RC,96360,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,57.12,
IV INF/HYDRAT 1ST HR-OBS,3040013,CDM,260,RC,96360,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,57.12,
IV INF/HYDRAT ADD HR,3230945,CDM,260,RC,96361,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,53.67,
IV INF/MED 1ST HR,3060310,CDM,260,RC,96365,HCPCS,outpatient,,,157,78.5,,102.05,65,,,percent of total billed charges,65% of total billed charges,106.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.4,20,,,percent of total billed charges,20% of total billed charges,31.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.4,20,,,percent of total billed charges,20% of total billed charges,31.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.05,65,,,percent of total billed charges,65% of total billed charges,102.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.4,106.76,
IV INF/MED 1ST HR,3230947,CDM,260,RC,96365,HCPCS,outpatient,,,157,78.5,,102.05,65,,,percent of total billed charges,65% of total billed charges,106.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.4,20,,,percent of total billed charges,20% of total billed charges,31.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.4,20,,,percent of total billed charges,20% of total billed charges,31.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.05,65,,,percent of total billed charges,65% of total billed charges,102.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.4,106.76,
IV INF/MED 1ST HR-OBSERV,3040015,CDM,260,RC,96365,HCPCS,outpatient,,,157,78.5,,102.05,65,,,percent of total billed charges,65% of total billed charges,106.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.4,20,,,percent of total billed charges,20% of total billed charges,31.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.4,20,,,percent of total billed charges,20% of total billed charges,31.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.05,65,,,percent of total billed charges,65% of total billed charges,102.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.4,106.76,
IV INF/MED ADD HR,3230949,CDM,260,RC,96366,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IV INF/SEQ MED 1ST HR-OBS,3040017,CDM,260,RC,96367,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
IV INF/SEQ MED 1STHR,3060311,CDM,260,RC,96367,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
IV INF/SEQ MED 1STHR,3230951,CDM,260,RC,96367,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
IV INFUSION/HYDRATION ADD 1 HR-OR,3060301,CDM,260,RC,96361,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,53.67,
IV INFUSION/MEDICATION ADD HR-OR,3060303,CDM,260,RC,96366,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IV LACT RING 5% DEX,3520299,CDM,258,RC,,,outpatient,,,60,30,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IV NACL 0.9% 100ML 2B1302,3521893,CDM,258,RC,,,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,53.67,
IV NACL 50 MINI+,3521923,CDM,272,RC,,,outpatient,,,21.4,10.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.28,20,,,percent of total billed charges,20% of total billed charges,4.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.28,20,,,percent of total billed charges,20% of total billed charges,4.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.91,65,,,percent of total billed charges,65% of total billed charges,13.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.28,53.67,
IV PRIMARY  2C8571,3250571,CDM,272,RC,,,outpatient,,,34.95,17.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.99,20,,,percent of total billed charges,20% of total billed charges,6.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.99,20,,,percent of total billed charges,20% of total billed charges,6.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.72,65,,,percent of total billed charges,65% of total billed charges,22.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.99,53.67,
IV PUSH,3230959,CDM,450,RC,96374,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,50,,,percent of total billed charges,50% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,57.12,
IV PUSH 15 MINUTES - OR,3060307,CDM,260,RC,96374,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IV PUSH NEW/SEQ MED- OR,3060308,CDM,260,RC,96375,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,57.12,
IV PUSH SAME MED 30 MIN-OR,3060309,CDM,260,RC,96376,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IV REMOVE CENT LINE,3230929,CDM,450,RC,36589,HCPCS,outpatient,,,437,218.5,,284.05,65,,,percent of total billed charges,65% of total billed charges,297.16,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,284.05,65,,,percent of total billed charges,65% of total billed charges,284.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,312,
IV SEC 11953,3250573,CDM,272,RC,,,outpatient,,,8.45,4.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.69,20,,,percent of total billed charges,20% of total billed charges,1.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.69,20,,,percent of total billed charges,20% of total billed charges,1.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.49,65,,,percent of total billed charges,65% of total billed charges,5.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.69,53.67,
IV SOD CHLOR 0.9% 50ML,3521861,CDM,258,RC,,,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,53.67,
IV-0.9 ADDV NACL 250,3521919,CDM,258,RC,,,outpatient,,,62,31,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.3,65,,,percent of total billed charges,65% of total billed charges,40.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.4,53.67,
IV-5% DEX 50ML,3521895,CDM,258,RC,,,outpatient,,,52,26,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.4,53.67,
IV-DEX 5 1M,3520297,CDM,258,RC,,,outpatient,,,26.1,13.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.22,20,,,percent of total billed charges,20% of total billed charges,5.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.22,20,,,percent of total billed charges,20% of total billed charges,5.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.97,65,,,percent of total billed charges,65% of total billed charges,16.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.22,53.67,
IV-DEX 5 250,3520293,CDM,258,RC,,,outpatient,,,49,24.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.8,20,,,percent of total billed charges,20% of total billed charges,9.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.8,20,,,percent of total billed charges,20% of total billed charges,9.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.85,65,,,percent of total billed charges,65% of total billed charges,31.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.8,53.67,
IV-DEX 5 500,3520295,CDM,258,RC,,,outpatient,,,57,28.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,53.67,
IV-DEX 5 500 2B0063Q,3520294,CDM,258,RC,,,outpatient,,,54,27,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.1,65,,,percent of total billed charges,65% of total billed charges,35.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,53.67,
IV-DEX 5 500-1522-03,3520291,CDM,258,RC,,,outpatient,,,57,28.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,20,,,percent of total billed charges,20% of total billed charges,11.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.05,65,,,percent of total billed charges,65% of total billed charges,37.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,53.67,
IV-DEX 5 NACL 1/2 1M,3521871,CDM,258,RC,,,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IV-DEX 5 NACL 1/3 1M,3521869,CDM,258,RC,,,outpatient,,,62,31,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.3,65,,,percent of total billed charges,65% of total billed charges,40.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.4,53.67,
IV-DEX 5 NACL 1/4 1M,3521867,CDM,258,RC,,,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IV-DEX 5 NACL 9 1M,3521875,CDM,258,RC,,,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IV-DEX 5 NACL 9 500,3521873,CDM,258,RC,,,outpatient,,,59,29.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.35,65,,,percent of total billed charges,65% of total billed charges,38.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.8,53.67,
IV-DEX 5% SOD CHL0.45% 500 ML,3521868,CDM,258,RC,,,outpatient,,,63,31.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.95,65,,,percent of total billed charges,65% of total billed charges,40.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,53.67,
IV-LACT RINGER 1000,3520301,CDM,258,RC,,,outpatient,,,60,30,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IV-NACL 0.9% 1000 ML SNGL,3521924,CDM,258,RC,,,outpatient,,,54,27,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.1,65,,,percent of total billed charges,65% of total billed charges,35.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,53.67,
IV-NACL 0.9% 50 ML SNGL,3521922,CDM,258,RC,,,outpatient,,,26.85,13.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.37,20,,,percent of total billed charges,20% of total billed charges,5.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.37,20,,,percent of total billed charges,20% of total billed charges,5.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.45,65,,,percent of total billed charges,65% of total billed charges,17.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,53.67,
IV-NACL 45 1M,3521885,CDM,258,RC,,,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IV-NACL 9 250,3520289,CDM,258,RC,,,outpatient,,,54,27,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.1,65,,,percent of total billed charges,65% of total billed charges,35.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,53.67,
IV-NACL 9 500,3520285,CDM,258,RC,,,outpatient,,,63,31.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.95,65,,,percent of total billed charges,65% of total billed charges,40.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,53.67,
IV-NACL 9 MIN BAG 50ML,3521887,CDM,258,RC,,,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,53.67,
IV-NACL 9 PF MIN BG 100ML,3521899,CDM,258,RC,,,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,53.67,
IV-NORM R DEX 5 1M,3521881,CDM,258,RC,,,outpatient,,,62,31,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.3,65,,,percent of total billed charges,65% of total billed charges,40.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.4,53.67,
IV-SC 9 1000 ML,3520283,CDM,258,RC,,,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IV-SOD CHLOR 250MLAD,3521891,CDM,258,RC,,,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.2,53.67,
IV/INF HYDRAT ADD HR-OBS,3040014,CDM,260,RC,96361,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,53.67,
IV/INF MED ADD HR-OBSERV,3040016,CDM,260,RC,96366,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,53.67,
IVF- DEX 5%/ 0.2% SOD CL,3500900,CDM,250,RC,J3490,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IVF- DEX 5%/ 0.45% SOD CL,3500901,CDM,250,RC,J3490,HCPCS,outpatient,,,63,31.5,,40.95,65,,,percent of total billed charges,65% of total billed charges,42.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.95,65,,,percent of total billed charges,65% of total billed charges,40.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,53.67,
IVF- DEX 5%/ 0.9% SOD CL,3500902,CDM,636,RC,J7042,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- DEX 5%/ LACT RING [1,3500903,CDM,250,RC,J3490,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IVF- DEX 5%/ PLASMALYTE 5,3500904,CDM,250,RC,J3490,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IVF- DEXTROSE 5% [1000 ML,3500905,CDM,636,RC,J7070,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- DEXTROSE 5% [250 ML],3500906,CDM,636,RC,J7060,HCPCS,outpatient,,,54,27,,,,,,other,Not reimbursable per contract ,36.72,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,80,,,case rate,80% for high cost drug carve out,45.9,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,45.9,
IVF- LACTATED RINGERS [10,3500908,CDM,636,RC,J7120,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- POT CL BOLUS [10 MEQ,3500909,CDM,636,RC,J3480,HCPCS,outpatient,,,54,27,,,,,,other,Not reimbursable per contract ,36.72,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,80,,,case rate,80% for high cost drug carve out,45.9,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,45.9,
IVF- POT CL D5-1/2NACL PR,3500910,CDM,636,RC,J3480,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- POT CL D51/2NACL PRE,3500911,CDM,636,RC,J3480,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- POT CL D5NS 1000 ML,3500912,CDM,636,RC,J3480,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- POT CL/ D51/2NACL PR,3500913,CDM,636,RC,J3480,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- POT CL/ NACL 0.9% PR,3500914,CDM,636,RC,J3480,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- POT CL/ NACL 0.9% PR,3500915,CDM,636,RC,J3480,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- POT CL/0.45% NACL PR,3500916,CDM,636,RC,J3480,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- SOD CL 0.45% [1000 M,3500917,CDM,250,RC,J3490,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
IVF- SOD CL 0.9% [100 ML],3500918,CDM,250,RC,J3490,HCPCS,outpatient,,,54,27,,35.1,65,,,percent of total billed charges,65% of total billed charges,36.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.1,65,,,percent of total billed charges,65% of total billed charges,35.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,53.67,
IVF- SOD CL 0.9% [1000 ML,3500919,CDM,636,RC,J7030,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,44.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,80,,,case rate,80% for high cost drug carve out,56.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,56.1,
IVF- SOD CL 0.9% [250 ML],3500920,CDM,636,RC,J7050,HCPCS,outpatient,,,54,27,,,,,,other,Not reimbursable per contract ,36.72,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,80,,,case rate,80% for high cost drug carve out,45.9,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,45.9,
IVF- SOD CL 0.9% [50 ML],3500921,CDM,250,RC,J3490,HCPCS,outpatient,,,26.85,13.43,,17.45,65,,,percent of total billed charges,65% of total billed charges,18.26,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.37,20,,,percent of total billed charges,20% of total billed charges,5.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.37,20,,,percent of total billed charges,20% of total billed charges,5.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.45,65,,,percent of total billed charges,65% of total billed charges,17.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.37,53.67,
IVF- SOD CL 0.9% [500 ML],3500922,CDM,636,RC,J7040,HCPCS,outpatient,,,63,31.5,,,,,,other,Not reimbursable per contract ,42.84,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,80,,,case rate,80% for high cost drug carve out,53.55,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,53.55,
IVF-SOD CL 3% [500 ML],3501044,CDM,250,RC,J7131,HCPCS,outpatient,,,63,31.5,,40.95,65,,,percent of total billed charges,65% of total billed charges,42.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.95,65,,,percent of total billed charges,65% of total billed charges,40.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,53.67,
JEVITY 1.2 BAG,3250025,CDM,250,RC,,,outpatient,,,30.55,15.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.11,20,,,percent of total billed charges,20% of total billed charges,6.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.11,20,,,percent of total billed charges,20% of total billed charges,6.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.86,65,,,percent of total billed charges,65% of total billed charges,19.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.11,53.67,
JEVITY 1.5 BAG,3250027,CDM,250,RC,,,outpatient,,,32,16,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.4,20,,,percent of total billed charges,20% of total billed charges,6.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.4,20,,,percent of total billed charges,20% of total billed charges,6.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.8,65,,,percent of total billed charges,65% of total billed charges,20.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.4,53.67,
Jo-1 ANTIBODY,3300934,CDM,300,RC,86235,HCPCS,outpatient,,,47.96,23.98,,31.17,65,,,percent of total billed charges,65% of total billed charges,32.61,68,,,percent of total billed charges,68% of total billed charges,25.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.59,20,,,percent of total billed charges,20% of total billed charges,9.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.59,20,,,percent of total billed charges,20% of total billed charges,9.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.17,65,,,percent of total billed charges,65% of total billed charges,31.17,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.98,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.59,32.61,
K/Y JELLY 2 OZ PKT,3250003,CDM,272,RC,,,outpatient,,,13.8,6.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.76,20,,,percent of total billed charges,20% of total billed charges,2.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.76,20,,,percent of total billed charges,20% of total billed charges,2.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.97,65,,,percent of total billed charges,65% of total billed charges,8.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.76,53.67,
KANGAROO TUBE GASTRO 18F,3250527,CDM,272,RC,,,outpatient,,,114.05,57.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.81,20,,,percent of total billed charges,20% of total billed charges,22.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.81,20,,,percent of total billed charges,20% of total billed charges,22.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.13,65,,,percent of total billed charges,65% of total billed charges,74.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.81,74.13,
KCL 10MEG D5 1/2,3521905,CDM,250,RC,,,outpatient,,,23.2,11.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.64,20,,,percent of total billed charges,20% of total billed charges,4.64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.64,20,,,percent of total billed charges,20% of total billed charges,4.64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.08,65,,,percent of total billed charges,65% of total billed charges,15.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.64,53.67,
KCL 20MEQ D5 1/2,3521907,CDM,250,RC,,,outpatient,,,19.2,9.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,20,,,percent of total billed charges,20% of total billed charges,3.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,20,,,percent of total billed charges,20% of total billed charges,3.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.48,65,,,percent of total billed charges,65% of total billed charges,12.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,53.67,
KEPPRA,3300465,CDM,301,RC,82542,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,24.09,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,61.2,
KERLIX 4 IN,3250503,CDM,272,RC,,,outpatient,,,11.45,5.73,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.29,20,,,percent of total billed charges,20% of total billed charges,2.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.29,20,,,percent of total billed charges,20% of total billed charges,2.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.44,65,,,percent of total billed charges,65% of total billed charges,7.44,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.29,53.67,
KETAMINE INJ [50 MG/ML],3501010,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
KETOCONAZOLE 2% CRM,3500472,CDM,250,RC,J3490,HCPCS,outpatient,,,43.8,21.9,,28.47,65,,,percent of total billed charges,65% of total billed charges,29.78,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.76,20,,,percent of total billed charges,20% of total billed charges,8.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.76,20,,,percent of total billed charges,20% of total billed charges,8.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.47,65,,,percent of total billed charges,65% of total billed charges,28.47,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.76,53.67,
KETOCONAZOLE 2% SHM,3500473,CDM,250,RC,J3490,HCPCS,outpatient,,,138.9,69.45,,90.29,65,,,percent of total billed charges,65% of total billed charges,94.45,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.78,20,,,percent of total billed charges,20% of total billed charges,27.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.78,20,,,percent of total billed charges,20% of total billed charges,27.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90.29,65,,,percent of total billed charges,65% of total billed charges,90.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,83.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.78,94.45,
KETOROLAC INJ [15 MG/1 ML,3500474,CDM,636,RC,J1885,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
KETOROLAC INJ [30 MG/ML],3500475,CDM,636,RC,J1885,HCPCS,outpatient,,,31.05,15.53,,,,,,other,Not reimbursable per contract ,21.11,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.21,20,,,percent of total billed charges,20% of total billed charges,6.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.21,20,,,percent of total billed charges,20% of total billed charges,6.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.84,80,,,case rate,80% for high cost drug carve out,26.39,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.21,26.39,
KETOROLAC INJ [60 MG/2 ML,3500476,CDM,636,RC,J1885,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
KETOSTEROIDS 17 24HR,3300125,CDM,301,RC,83582,HCPCS,outpatient,,,82,41,,53.3,65,,,percent of total billed charges,65% of total billed charges,55.76,68,,,percent of total billed charges,68% of total billed charges,20.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.4,20,,,percent of total billed charges,20% of total billed charges,16.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.4,20,,,percent of total billed charges,20% of total billed charges,16.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.3,65,,,percent of total billed charges,65% of total billed charges,53.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.4,55.76,
KIDDOGRAM,3400110,CDM,320,RC,77076,HCPCS,outpatient,,,442.2,221.1,,287.43,65,,,percent of total billed charges,65% of total billed charges,300.7,68,,,percent of total billed charges,68% of total billed charges,24.76,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.44,20,,,percent of total billed charges,20% of total billed charges,88.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.44,20,,,percent of total billed charges,20% of total billed charges,88.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,287.43,65,,,percent of total billed charges,65% of total billed charges,287.43,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,265.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.76,300.7,
KIDDOGRAM,3440121,CDM,972,RC,77076,HCPCS,outpatient,,,62.7,31.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,52.9,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.97,110,,,fee schedule,110% of Medicare physician fee schedule,68.97,110,,,fee schedule,110% of Medicare physician fee schedule,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.11,115,,,fee schedule,115% of Medicare physician fee schedule,105.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,79.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.9,105.5,
KING TUBE SIZE 4,3170116,CDM,272,RC,,,outpatient,,,84.56,42.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.91,20,,,percent of total billed charges,20% of total billed charges,16.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.91,20,,,percent of total billed charges,20% of total billed charges,16.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.96,65,,,percent of total billed charges,65% of total billed charges,54.96,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.91,54.96,
KITTNER DISSECTOR 5PK,6215855,CDM,272,RC,,,outpatient,,,18.45,9.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.69,20,,,percent of total billed charges,20% of total billed charges,3.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.69,20,,,percent of total billed charges,20% of total billed charges,3.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.99,65,,,percent of total billed charges,65% of total billed charges,11.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.69,53.67,
KLING 2 IN STERILE,3250443,CDM,272,RC,,,outpatient,,,3.7,1.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.74,20,,,percent of total billed charges,20% of total billed charges,0.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.74,20,,,percent of total billed charges,20% of total billed charges,0.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.41,65,,,percent of total billed charges,65% of total billed charges,2.41,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.74,53.67,
KLING 3IN STERILE,3250471,CDM,272,RC,,,outpatient,,,7.6,3.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.52,20,,,percent of total billed charges,20% of total billed charges,1.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.52,20,,,percent of total billed charges,20% of total billed charges,1.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.94,65,,,percent of total billed charges,65% of total billed charges,4.94,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.52,53.67,
KNEE 2 VIEW BIL,3400088,CDM,320,RC,73560,HCPCS,outpatient,,,220,110,,143,65,,,percent of total billed charges,65% of total billed charges,149.6,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
KNEE 2 VIEW L,3400006,CDM,320,RC,73560,HCPCS,outpatient,,,175,87.5,,113.75,65,,,percent of total billed charges,65% of total billed charges,119,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.75,65,,,percent of total billed charges,65% of total billed charges,113.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
KNEE 2 VIEW RT,3400087,CDM,320,RC,73560,HCPCS,outpatient,,,175,87.5,,113.75,65,,,percent of total billed charges,65% of total billed charges,119,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.75,65,,,percent of total billed charges,65% of total billed charges,113.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
KNEE 4/VIEW LT,3440131,CDM,972,RC,73564,HCPCS,outpatient,,,63.8,31.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.92,110,,,fee schedule,110% of Medicare physician fee schedule,49.92,110,,,fee schedule,110% of Medicare physician fee schedule,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,228.59,115,,,fee schedule,115% of Medicare physician fee schedule,74.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,21.74,228.59,
KNEE 4/VIEW RT,3440133,CDM,972,RC,73564,HCPCS,outpatient,,,63.8,31.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.92,110,,,fee schedule,110% of Medicare physician fee schedule,49.92,110,,,fee schedule,110% of Medicare physician fee schedule,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,228.59,115,,,fee schedule,115% of Medicare physician fee schedule,74.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,21.74,228.59,
KNEE BIL MIN 2 V,3440123,CDM,972,RC,73560,HCPCS,outpatient,,,80.3,40.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.83,110,,,fee schedule,110% of Medicare physician fee schedule,36.83,110,,,fee schedule,110% of Medicare physician fee schedule,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.9,115,,,fee schedule,115% of Medicare physician fee schedule,69.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,214.9,
KNEE BILATERAL 4/VIE,3440129,CDM,972,RC,73564,HCPCS,outpatient,,,116.6,58.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.92,110,,,fee schedule,110% of Medicare physician fee schedule,49.92,110,,,fee schedule,110% of Medicare physician fee schedule,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,228.59,115,,,fee schedule,115% of Medicare physician fee schedule,74.34,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,21.74,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,21.74,228.59,
KNEE LT MIN 2 V,3440125,CDM,972,RC,73560,HCPCS,outpatient,,,46.2,23.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.83,110,,,fee schedule,110% of Medicare physician fee schedule,36.83,110,,,fee schedule,110% of Medicare physician fee schedule,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.9,115,,,fee schedule,115% of Medicare physician fee schedule,69.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,214.9,
KNEE RT MIN 2 V,3440127,CDM,972,RC,73560,HCPCS,outpatient,,,46.2,23.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.83,110,,,fee schedule,110% of Medicare physician fee schedule,36.83,110,,,fee schedule,110% of Medicare physician fee schedule,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.9,115,,,fee schedule,115% of Medicare physician fee schedule,69.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.89,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.89,214.9,
KNEE-BIL 4 VIEWS,3400090,CDM,320,RC,73564,HCPCS,outpatient,,,450,225,,292.5,65,,,percent of total billed charges,65% of total billed charges,306,68,,,percent of total billed charges,68% of total billed charges,20.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,20,,,percent of total billed charges,20% of total billed charges,90,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,20,,,percent of total billed charges,20% of total billed charges,90,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,292.5,65,,,percent of total billed charges,65% of total billed charges,292.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.77,306,
KNEE-L 4 VIEWS,3400014,CDM,320,RC,73564,HCPCS,outpatient,,,195,97.5,,126.75,65,,,percent of total billed charges,65% of total billed charges,132.6,68,,,percent of total billed charges,68% of total billed charges,20.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.75,65,,,percent of total billed charges,65% of total billed charges,126.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.77,180,
KNEE-R 4 VIEWS,3400089,CDM,320,RC,73564,HCPCS,outpatient,,,195,97.5,,126.75,65,,,percent of total billed charges,65% of total billed charges,132.6,68,,,percent of total billed charges,68% of total billed charges,20.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.75,65,,,percent of total billed charges,65% of total billed charges,126.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.77,180,
KOH FOR FUNGI/PARAS/MITES,3400193,CDM,306,RC,87220,HCPCS,outpatient,,,10,5,,6.5,65,,,percent of total billed charges,65% of total billed charges,6.8,68,,,percent of total billed charges,68% of total billed charges,6.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.5,65,,,percent of total billed charges,65% of total billed charges,6.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2,6.8,
KOH PREP,3300751,CDM,306,RC,87210,HCPCS,outpatient,,,20,10,,13,65,,,percent of total billed charges,65% of total billed charges,13.6,68,,,percent of total billed charges,68% of total billed charges,6.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,13.6,
KUB SINGLE VIEW,3400007,CDM,320,RC,74018,HCPCS,outpatient,,,300,150,,195,65,,,percent of total billed charges,65% of total billed charges,204,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,65,,,percent of total billed charges,65% of total billed charges,195,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,204,
KUB SNGL V,3440119,CDM,972,RC,74018,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.12,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.32,110,,,fee schedule,110% of Medicare physician fee schedule,32.32,110,,,fee schedule,110% of Medicare physician fee schedule,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,210.19,115,,,fee schedule,115% of Medicare physician fee schedule,67.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.12,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.17,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.12,210.19,
KY JELLY [2 OZ],3500477,CDM,250,RC,J3490,HCPCS,outpatient,,,11.7,5.85,,7.61,65,,,percent of total billed charges,65% of total billed charges,7.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.34,20,,,percent of total billed charges,20% of total billed charges,2.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.34,20,,,percent of total billed charges,20% of total billed charges,2.34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.61,65,,,percent of total billed charges,65% of total billed charges,7.61,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.34,53.67,
KY JELLY [4 OZ],3500478,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
KY JELLY DOSE 2.7 GRAMS,3250647,CDM,272,RC,,,outpatient,,,2.25,1.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.45,20,,,percent of total billed charges,20% of total billed charges,0.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.45,20,,,percent of total billed charges,20% of total billed charges,0.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.46,65,,,percent of total billed charges,65% of total billed charges,1.46,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.45,53.67,
"L-HOOK, ELECTRO",6215836,CDM,272,RC,,,outpatient,,,181.25,90.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.25,20,,,percent of total billed charges,20% of total billed charges,36.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.25,20,,,percent of total billed charges,20% of total billed charges,36.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117.81,65,,,percent of total billed charges,65% of total billed charges,117.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.25,117.81,
LAB-GLUCOSE POS,3700045,CDM,301,RC,82962,HCPCS,outpatient,,,18,9,,11.7,65,,,percent of total billed charges,65% of total billed charges,12.24,68,,,percent of total billed charges,68% of total billed charges,4.49,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.7,65,,,percent of total billed charges,65% of total billed charges,11.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,12.24,
LAB-HEMATOCRIT,3700053,CDM,305,RC,85014,HCPCS,outpatient,,,18,9,,11.7,65,,,percent of total billed charges,65% of total billed charges,12.24,68,,,percent of total billed charges,68% of total billed charges,3.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.7,65,,,percent of total billed charges,65% of total billed charges,11.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.36,12.24,
LAB-HEMOGLOBIN,3700051,CDM,305,RC,85018,HCPCS,outpatient,,,18,9,,11.7,65,,,percent of total billed charges,65% of total billed charges,12.24,68,,,percent of total billed charges,68% of total billed charges,3.35,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.7,65,,,percent of total billed charges,65% of total billed charges,11.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.35,12.24,
LAB-OCCULT BLD FECAL,3700047,CDM,301,RC,82270,HCPCS,outpatient,,,18,9,,11.7,65,,,percent of total billed charges,65% of total billed charges,12.24,68,,,percent of total billed charges,68% of total billed charges,3.59,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.7,65,,,percent of total billed charges,65% of total billed charges,11.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.59,12.24,
LAB-PREG TEST URINE,3700057,CDM,307,RC,81025,HCPCS,outpatient,,,20,10,,13,65,,,percent of total billed charges,65% of total billed charges,13.6,68,,,percent of total billed charges,68% of total billed charges,8.98,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,13.6,
LABETALOL INJ [100 MG/20,3500479,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
LABETALOL INJ [100 MG/20,3500479,CDM,636,RC,J3490,HCPCS,outpatient,,,39.95,19.98,,,,,,other,Not reimbursable per contract ,27.17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.99,20,,,percent of total billed charges,20% of total billed charges,7.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.99,20,,,percent of total billed charges,20% of total billed charges,7.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.96,80,,,case rate,80% for high cost drug carve out,33.96,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.99,33.96,
LABETALOL TAB [100 MG],3500480,CDM,250,RC,J3490,HCPCS,outpatient,,,11.45,5.73,,7.44,65,,,percent of total billed charges,65% of total billed charges,7.79,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.29,20,,,percent of total billed charges,20% of total billed charges,2.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.29,20,,,percent of total billed charges,20% of total billed charges,2.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.44,65,,,percent of total billed charges,65% of total billed charges,7.44,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.29,53.67,
LACOSAMIDE LEVEL,3300635,CDM,301,RC,80299,HCPCS,outpatient,,,241.95,120.98,,157.27,65,,,percent of total billed charges,65% of total billed charges,164.53,68,,,percent of total billed charges,68% of total billed charges,19.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.39,20,,,percent of total billed charges,20% of total billed charges,48.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.39,20,,,percent of total billed charges,20% of total billed charges,48.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.27,65,,,percent of total billed charges,65% of total billed charges,157.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.98,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.43,164.53,
"LACTIC ACID, PLASMA",3300598,CDM,302,RC,83605,HCPCS,outpatient,,,94,47,,61.1,65,,,percent of total billed charges,65% of total billed charges,63.92,68,,,percent of total billed charges,68% of total billed charges,15.15,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.1,65,,,percent of total billed charges,65% of total billed charges,61.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.15,63.92,
LACTOBACILLUS TAB,3500482,CDM,250,RC,J3490,HCPCS,outpatient,,,5.7,2.85,,3.71,65,,,percent of total billed charges,65% of total billed charges,3.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.14,20,,,percent of total billed charges,20% of total billed charges,1.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.14,20,,,percent of total billed charges,20% of total billed charges,1.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.71,65,,,percent of total billed charges,65% of total billed charges,3.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.14,53.67,
LACTULOSE LIQ (10MG/15ML),3501087,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LAMICTAL LEVEL,3300347,CDM,301,RC,80299,HCPCS,outpatient,,,83,41.5,,53.95,65,,,percent of total billed charges,65% of total billed charges,56.44,68,,,percent of total billed charges,68% of total billed charges,19.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.95,65,,,percent of total billed charges,65% of total billed charges,53.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.6,56.44,
LAMOTRIGINE TAB [100 MG],3500484,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LANTISEPTIC CRM [4 OZ],3500899,CDM,250,RC,,,outpatient,,,7.2,3.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,20,,,percent of total billed charges,20% of total billed charges,1.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,20,,,percent of total billed charges,20% of total billed charges,1.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.68,65,,,percent of total billed charges,65% of total billed charges,4.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,53.67,
LAP APPENDECTOMY,3462037,CDM,982,RC,44970,HCPCS,outpatient,,,854,427,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,432.21,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,697.57,110,,,fee schedule,110% of Medicare physician fee schedule,697.57,110,,,fee schedule,110% of Medicare physician fee schedule,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,729.27,115,,,fee schedule,115% of Medicare physician fee schedule,484.81,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,802.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,432.21,802.2,
LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRG,3462076,CDM,982,RC,49653,HCPCS,outpatient,,,1325,662.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,668.59,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,721.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,668.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,668.59,721.19,
LAPRO DISSECTOR,6215834,CDM,272,RC,,,outpatient,,,247.5,123.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,20,,,percent of total billed charges,20% of total billed charges,49.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,20,,,percent of total billed charges,20% of total billed charges,49.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.88,65,,,percent of total billed charges,65% of total billed charges,160.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.5,160.88,
LAPRO SCISSORS,6215835,CDM,272,RC,,,outpatient,,,209,104.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.8,20,,,percent of total billed charges,20% of total billed charges,41.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.8,20,,,percent of total billed charges,20% of total billed charges,41.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.85,65,,,percent of total billed charges,65% of total billed charges,135.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,125.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.8,135.85,
LAPS  RPR INITAL INGUINAL HERNIA,3462022,CDM,982,RC,49650,HCPCS,outpatient,,,608,304,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,310.19,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,499.44,110,,,fee schedule,110% of Medicare physician fee schedule,499.44,110,,,fee schedule,110% of Medicare physician fee schedule,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,522.15,115,,,fee schedule,115% of Medicare physician fee schedule,362.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,310.19,100,,,fee schedule,100% of FL Medicaid fee schedule ,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,574.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,310.19,574.36,
LAPS  RPR RECURRENT INGUINAL HERNIA,3462023,CDM,982,RC,49651,HCPCS,outpatient,,,792,396,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,403.8,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,653.32,110,,,fee schedule,110% of Medicare physician fee schedule,653.32,110,,,fee schedule,110% of Medicare physician fee schedule,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,683.02,115,,,fee schedule,115% of Medicare physician fee schedule,456.4,100,,,fee schedule,100% of FL Medicaid fee schedule ,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,403.8,100,,,fee schedule,100% of FL Medicaid fee schedule ,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,751.32,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,403.8,751.32,
LAPS CHOLECYSTECOMY W/O IOC,3462030,CDM,982,RC,47562,HCPCS,outpatient,,,940,470,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,474.21,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,764.56,110,,,fee schedule,110% of Medicare physician fee schedule,764.56,110,,,fee schedule,110% of Medicare physician fee schedule,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,799.31,115,,,fee schedule,115% of Medicare physician fee schedule,526.81,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,474.21,100,,,fee schedule,100% of FL Medicaid fee schedule ,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,879.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,474.21,879.24,
LAPS CHOLECYSTECTOMY CHOLANGIO,3462025,CDM,982,RC,47563,HCPCS,outpatient,,,1022,511,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,515.96,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,834.31,110,,,fee schedule,110% of Medicare physician fee schedule,834.31,110,,,fee schedule,110% of Medicare physician fee schedule,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,872.23,115,,,fee schedule,115% of Medicare physician fee schedule,568.56,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,959.45,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,515.96,959.45,
LAPS RPR HERNIA EXCEPT INCIS/INGUN REDUC,3462075,CDM,982,RC,49652,HCPCS,outpatient,,,1060,530,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,533.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,586.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,533.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,533.72,586.32,
LAPS RPR INCISIONAL HENIA REDUCIBLE,3462024,CDM,982,RC,49654,HCPCS,outpatient,,,1206,603,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,605.48,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,658.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,605.48,658.08,
LAPS RPR INCISIONAL HERNIA NCRC8/STRANG,3462017,CDM,982,RC,49655,HCPCS,outpatient,,,1458,729,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,742.03,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,794.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,742.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,742.03,794.63,
LAPS RPR RECURRENT INCAL HRNA NCRC8/STRG,3462019,CDM,982,RC,49657,HCPCS,outpatient,,,1892,946,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,944.33,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,996.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,944.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,944.33,996.93,
LAPS RPR RECURRENT INCISIONAL HERNIA,3462018,CDM,982,RC,49656,HCPCS,outpatient,,,1310,655,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,657.79,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,710.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,657.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,657.79,710.39,
LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MUL,3462090,CDM,982,RC,49322,HCPCS,outpatient,,,528,264,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,268.3,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,432.84,110,,,fee schedule,110% of Medicare physician fee schedule,432.84,110,,,fee schedule,110% of Medicare physician fee schedule,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,452.51,115,,,fee schedule,115% of Medicare physician fee schedule,320.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,497.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,268.3,497.76,
LATANOPROST DRP,3500487,CDM,250,RC,J3490,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,129.2,
LATIS. GRASP,6215833,CDM,272,RC,,,outpatient,,,247.5,123.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,20,,,percent of total billed charges,20% of total billed charges,49.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,20,,,percent of total billed charges,20% of total billed charges,49.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.88,65,,,percent of total billed charges,65% of total billed charges,160.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.5,160.88,
LDH,3300059,CDM,301,RC,83615,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,8.57,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
LDH ISOENZYMES,3300191,CDM,301,RC,83625,HCPCS,outpatient,,,78,39,,50.7,65,,,percent of total billed charges,65% of total billed charges,53.04,68,,,percent of total billed charges,68% of total billed charges,18.16,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,20,,,percent of total billed charges,20% of total billed charges,15.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,20,,,percent of total billed charges,20% of total billed charges,15.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.7,65,,,percent of total billed charges,65% of total billed charges,50.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.6,53.04,
LEAD,3300135,CDM,301,RC,83655,HCPCS,outpatient,,,61,30.5,,39.65,65,,,percent of total billed charges,65% of total billed charges,41.48,68,,,percent of total billed charges,68% of total billed charges,17.18,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.2,20,,,percent of total billed charges,20% of total billed charges,12.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.2,20,,,percent of total billed charges,20% of total billed charges,12.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.65,65,,,percent of total billed charges,65% of total billed charges,39.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.2,41.48,
LEGIONELLA TITER,3300527,CDM,302,RC,86713,HCPCS,outpatient,,,210,105,,136.5,65,,,percent of total billed charges,65% of total billed charges,142.8,68,,,percent of total billed charges,68% of total billed charges,21.72,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,20,,,percent of total billed charges,20% of total billed charges,42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,20,,,percent of total billed charges,20% of total billed charges,42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.5,65,,,percent of total billed charges,65% of total billed charges,136.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.72,142.8,
LEMON GLYCERIN SWABS,3250345,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
LEVEL 1 EST PT,3700110,CDM,510,RC,99211,HCPCS,outpatient,,,101,50.5,,65.65,65,,,percent of total billed charges,65% of total billed charges,68.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.65,65,,,percent of total billed charges,65% of total billed charges,65.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,68.68,
LEVEL 1 EST PT PRO FEE,3700073,CDM,983,RC,99211,HCPCS,outpatient,,,74,37,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,5.51,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,9.61,109,,,fee schedule,109% of Medicare physician fee schedule,19.32,109,,,fee schedule,109% of Medicare physician fee schedule,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.14,115,,,fee schedule,115% of Medicare physician fee schedule,58.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,5.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,11.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,5.51,58.11,
LEVEL 1 NEW PT,3700063,CDM,510,RC,99201,HCPCS,outpatient,,,148,74,,96.2,65,,,percent of total billed charges,65% of total billed charges,100.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.6,20,,,percent of total billed charges,20% of total billed charges,29.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.6,20,,,percent of total billed charges,20% of total billed charges,29.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.2,65,,,percent of total billed charges,65% of total billed charges,96.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,88.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.6,100.64,
LEVEL 1 NEW PT PRO FEE,3700277,CDM,983,RC,99201,HCPCS,outpatient,,,89,44.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,52.6,
LEVEL 2 EST PT,3700075,CDM,510,RC,99212,HCPCS,outpatient,,,146,73,,94.9,65,,,percent of total billed charges,65% of total billed charges,99.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.2,20,,,percent of total billed charges,20% of total billed charges,29.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.2,20,,,percent of total billed charges,20% of total billed charges,29.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.9,65,,,percent of total billed charges,65% of total billed charges,94.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.2,99.28,
LEVEL 2 EST PT PRO FEE,3700278,CDM,983,RC,99212,HCPCS,outpatient,,,86,43,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.48,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,109,,,fee schedule,109% of Medicare physician fee schedule,78.62,109,,,fee schedule,109% of Medicare physician fee schedule,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.29,115,,,fee schedule,115% of Medicare physician fee schedule,70.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,45.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.48,78.62,
LEVEL 2 NEW PR PRO FEE,3700279,CDM,983,RC,99202,HCPCS,outpatient,,,168,84,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,33,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.87,109,,,fee schedule,109% of Medicare physician fee schedule,106.22,109,,,fee schedule,109% of Medicare physician fee schedule,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.78,115,,,fee schedule,115% of Medicare physician fee schedule,85.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,33,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,33,106.22,
LEVEL 2 NEW PT,3700065,CDM,510,RC,99202,HCPCS,outpatient,,,246,123,,159.9,65,,,percent of total billed charges,65% of total billed charges,167.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.2,20,,,percent of total billed charges,20% of total billed charges,49.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.2,20,,,percent of total billed charges,20% of total billed charges,49.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.9,65,,,percent of total billed charges,65% of total billed charges,159.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.2,167.28,
LEVEL 3 EST PT,3700077,CDM,510,RC,99213,HCPCS,outpatient,,,300,150,,195,65,,,percent of total billed charges,65% of total billed charges,204,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,65,,,percent of total billed charges,65% of total billed charges,195,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,204,
LEVEL 3 EST PT PRO FEE,3700276,CDM,983,RC,99213,HCPCS,outpatient,,,242,121,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.62,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.47,109,,,fee schedule,109% of Medicare physician fee schedule,145.61,109,,,fee schedule,109% of Medicare physician fee schedule,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.46,115,,,fee schedule,115% of Medicare physician fee schedule,82.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.62,145.61,
LEVEL 3 NEW PT,3700067,CDM,510,RC,99203,HCPCS,outpatient,,,349,174.5,,226.85,65,,,percent of total billed charges,65% of total billed charges,237.32,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.8,20,,,percent of total billed charges,20% of total billed charges,69.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.8,20,,,percent of total billed charges,20% of total billed charges,69.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,226.85,65,,,percent of total billed charges,65% of total billed charges,226.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,237.32,
LEVEL 3 NEW PT PRO FEE,3700280,CDM,983,RC,99203,HCPCS,outpatient,,,251,125.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.23,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,91.81,109,,,fee schedule,109% of Medicare physician fee schedule,184.46,109,,,fee schedule,109% of Medicare physician fee schedule,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,96.86,115,,,fee schedule,115% of Medicare physician fee schedule,103.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,106.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.23,184.46,
LEVEL 4 EST PT,3700079,CDM,510,RC,99214,HCPCS,outpatient,,,352,176,,228.8,65,,,percent of total billed charges,65% of total billed charges,239.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.4,20,,,percent of total billed charges,20% of total billed charges,70.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.4,20,,,percent of total billed charges,20% of total billed charges,70.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,228.8,65,,,percent of total billed charges,65% of total billed charges,228.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,239.36,
LEVEL 4 EST PT PRO FEE,3700281,CDM,983,RC,99214,HCPCS,outpatient,,,261,130.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.15,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.89,109,,,fee schedule,109% of Medicare physician fee schedule,214.75,109,,,fee schedule,109% of Medicare physician fee schedule,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,112.77,115,,,fee schedule,115% of Medicare physician fee schedule,98.75,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.15,100,,,fee schedule,100% of FL Medicaid fee schedule ,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,124.05,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.15,214.75,
LEVEL 4 NEW PT,3700070,CDM,510,RC,99204,HCPCS,outpatient,,,537,268.5,,349.05,65,,,percent of total billed charges,65% of total billed charges,365.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.4,20,,,percent of total billed charges,20% of total billed charges,107.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.4,20,,,percent of total billed charges,20% of total billed charges,107.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,349.05,65,,,percent of total billed charges,65% of total billed charges,349.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,322.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,365.16,
LEVEL 4 NEW PT PRO FEE,3700069,CDM,983,RC,99204,HCPCS,outpatient,,,430,215,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,87.62,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.9,109,,,fee schedule,109% of Medicare physician fee schedule,295.15,109,,,fee schedule,109% of Medicare physician fee schedule,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,154.99,115,,,fee schedule,115% of Medicare physician fee schedule,140.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,87.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,170.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,87.62,295.15,
LEVEL 5 EST PT,3700081,CDM,510,RC,99215,HCPCS,outpatient,,,474,237,,308.1,65,,,percent of total billed charges,65% of total billed charges,322.32,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.8,20,,,percent of total billed charges,20% of total billed charges,94.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.8,20,,,percent of total billed charges,20% of total billed charges,94.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,308.1,65,,,percent of total billed charges,65% of total billed charges,308.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,284.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,322.32,
LEVEL 5 EST PT PRO FEE,3700282,CDM,983,RC,99215,HCPCS,outpatient,,,368,184,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.08,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,156.84,109,,,fee schedule,109% of Medicare physician fee schedule,315.12,109,,,fee schedule,109% of Medicare physician fee schedule,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,165.47,115,,,fee schedule,115% of Medicare physician fee schedule,119.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.08,100,,,fee schedule,100% of FL Medicaid fee schedule ,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,182.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.08,315.12,
LEVEL 5 NEW PT,3700071,CDM,510,RC,99205,HCPCS,outpatient,,,678,339,,440.7,65,,,percent of total billed charges,65% of total billed charges,461.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.6,20,,,percent of total billed charges,20% of total billed charges,135.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.6,20,,,percent of total billed charges,20% of total billed charges,135.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.7,65,,,percent of total billed charges,65% of total billed charges,440.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,406.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,461.04,
LEVEL 5 NEW PT PRO FEE,3700283,CDM,983,RC,99205,HCPCS,outpatient,,,560,280,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,114.42,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,199.36,109,,,fee schedule,109% of Medicare physician fee schedule,400.55,109,,,fee schedule,109% of Medicare physician fee schedule,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,210.34,115,,,fee schedule,115% of Medicare physician fee schedule,167.02,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,114.42,400.55,
LEVEL 5 SURG PATH,3300831,CDM,310,RC,88307,HCPCS,outpatient,,,219,109.5,,142.35,65,,,percent of total billed charges,65% of total billed charges,148.92,68,,,percent of total billed charges,68% of total billed charges,41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.8,20,,,percent of total billed charges,20% of total billed charges,43.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.8,20,,,percent of total billed charges,20% of total billed charges,43.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.35,65,,,percent of total billed charges,65% of total billed charges,142.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41,148.92,
LEVETIRACETAM INJ,3300437,CDM,250,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
LEVETIRACETAM SUSP [100 M,3501006,CDM,250,RC,J3490,HCPCS,outpatient,,,15.15,7.58,,9.85,65,,,percent of total billed charges,65% of total billed charges,10.3,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.03,20,,,percent of total billed charges,20% of total billed charges,3.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.03,20,,,percent of total billed charges,20% of total billed charges,3.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.85,65,,,percent of total billed charges,65% of total billed charges,9.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.03,53.67,
LEVETIRACETAM TAB (250MG),3501101,CDM,250,RC,,,outpatient,,,12.95,6.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.59,20,,,percent of total billed charges,20% of total billed charges,2.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.59,20,,,percent of total billed charges,20% of total billed charges,2.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.42,65,,,percent of total billed charges,65% of total billed charges,8.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.59,53.67,
LEVETIRACETAM TAB [500 MG,3500488,CDM,250,RC,J3490,HCPCS,outpatient,,,15.85,7.93,,10.3,65,,,percent of total billed charges,65% of total billed charges,10.78,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.17,20,,,percent of total billed charges,20% of total billed charges,3.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.17,20,,,percent of total billed charges,20% of total billed charges,3.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.3,65,,,percent of total billed charges,65% of total billed charges,10.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.17,53.67,
LEVETIRACETAM TAB [750 MG,3500988,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LEVOFLOXACIN TAB [250 MG],3500489,CDM,250,RC,J3490,HCPCS,outpatient,,,73.65,36.83,,47.87,65,,,percent of total billed charges,65% of total billed charges,50.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.73,20,,,percent of total billed charges,20% of total billed charges,14.73,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.73,20,,,percent of total billed charges,20% of total billed charges,14.73,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.87,65,,,percent of total billed charges,65% of total billed charges,47.87,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.73,53.67,
LEVOFLOXACIN TAB [500 MG],3500490,CDM,250,RC,J3490,HCPCS,outpatient,,,84.1,42.05,,54.67,65,,,percent of total billed charges,65% of total billed charges,57.19,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.82,20,,,percent of total billed charges,20% of total billed charges,16.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.82,20,,,percent of total billed charges,20% of total billed charges,16.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.67,65,,,percent of total billed charges,65% of total billed charges,54.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.82,57.19,
LEVOFLOXACIN TAB [750 MG],3500491,CDM,250,RC,J3490,HCPCS,outpatient,,,123.1,61.55,,80.02,65,,,percent of total billed charges,65% of total billed charges,83.71,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.62,20,,,percent of total billed charges,20% of total billed charges,24.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.62,20,,,percent of total billed charges,20% of total billed charges,24.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.02,65,,,percent of total billed charges,65% of total billed charges,80.02,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.62,83.71,
LEVOFLOXACIN/ D5W PREMIX,3500492,CDM,636,RC,J1956,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
LEVOFLOXACIN/ D5W PREMIX 750mg,3500493,CDM,636,RC,J1956,HCPCS,outpatient,,,70.2,35.1,,,,,,other,Not reimbursable per contract ,47.74,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.16,80,,,case rate,80% for high cost drug carve out,59.67,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.04,59.67,
LEVOFLOXACIN/D5W PREMIX 500mg,3501036,CDM,250,RC,J3490,HCPCS,outpatient,,,74.45,37.23,,48.39,65,,,percent of total billed charges,65% of total billed charges,50.63,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.89,20,,,percent of total billed charges,20% of total billed charges,14.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.89,20,,,percent of total billed charges,20% of total billed charges,14.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.39,65,,,percent of total billed charges,65% of total billed charges,48.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.89,53.67,
LEVOPHED INJ 4MG/4ML,3501123,CDM,636,RC,J3490,HCPCS,outpatient,,,102.45,51.23,,,,,,other,Not reimbursable per contract ,69.67,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.49,20,,,percent of total billed charges,20% of total billed charges,20.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.49,20,,,percent of total billed charges,20% of total billed charges,20.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.96,80,,,case rate,80% for high cost drug carve out,87.08,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.49,87.08,
LEVOTHYROXINE 200MCG,3521903,CDM,250,RC,,,outpatient,,,49.35,24.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.87,20,,,percent of total billed charges,20% of total billed charges,9.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.87,20,,,percent of total billed charges,20% of total billed charges,9.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.08,65,,,percent of total billed charges,65% of total billed charges,32.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.87,53.67,
LEVOTHYROXINE TAB  [112 M,3500970,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LEVOTHYROXINE TAB [100 MC,3500495,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LEVOTHYROXINE TAB [125 MC,3500496,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LEVOTHYROXINE TAB [25 MCG,3500497,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LEVOTHYROXINE TAB [50 MCG,3500498,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LEVOTHYROXINE TAB [75 MCG,3500499,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LEVOTHYROXINE TAB [88 MCG,3500500,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LG CLIP APPLIER,6215803,CDM,272,RC,,,outpatient,,,518.91,259.46,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.78,20,,,percent of total billed charges,20% of total billed charges,103.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.78,20,,,percent of total billed charges,20% of total billed charges,103.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,337.29,65,,,percent of total billed charges,65% of total billed charges,337.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,311.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,337.29,
LG NON-VENTED BIPAP/ CPAP MASK,3170112,CDM,272,RC,,,outpatient,,,154.28,77.14,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.86,20,,,percent of total billed charges,20% of total billed charges,30.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.86,20,,,percent of total billed charges,20% of total billed charges,30.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.28,65,,,percent of total billed charges,65% of total billed charges,100.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.86,100.28,
LIDOCAINE 1% INJ [ 20 ML/,3500501,CDM,636,RC,J2001,HCPCS,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,3.4,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,80,,,case rate,80% for high cost drug carve out,4.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,4.25,
LIDOCAINE 1% INJ [20MG/2M,3501073,CDM,250,RC,J3490,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
LIDOCAINE 1% PF,3521953,CDM,250,RC,,,outpatient,,,6.55,3.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.31,20,,,percent of total billed charges,20% of total billed charges,1.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.31,20,,,percent of total billed charges,20% of total billed charges,1.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.26,65,,,percent of total billed charges,65% of total billed charges,4.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.31,53.67,
LIDOCAINE 1GM/ D5W PREMIX,3500502,CDM,636,RC,J2001,HCPCS,outpatient,,,31.5,15.75,,,,,,other,Not reimbursable per contract ,21.42,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.3,20,,,percent of total billed charges,20% of total billed charges,6.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.3,20,,,percent of total billed charges,20% of total billed charges,6.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.2,80,,,case rate,80% for high cost drug carve out,26.78,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,26.78,
LIDOCAINE 2% INJ,3500503,CDM,636,RC,J2001,HCPCS,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,3.4,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,80,,,case rate,80% for high cost drug carve out,4.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,4.25,
LIDOCAINE 2% VISCOUS [100,3500504,CDM,250,RC,J3490,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
LIDOCAINE 4% 30GM,3521944,CDM,636,RC,J3490,HCPCS,outpatient,,,42,21,,,,,,other,Not reimbursable per contract ,28.56,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,20,,,percent of total billed charges,20% of total billed charges,8.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,20,,,percent of total billed charges,20% of total billed charges,8.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,80,,,case rate,80% for high cost drug carve out,35.7,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,35.7,
LIDOCAINE 4% 5GM,3521939,CDM,636,RC,J3490,HCPCS,outpatient,,,10.5,5.25,,,,,,other,Not reimbursable per contract ,7.14,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.1,20,,,percent of total billed charges,20% of total billed charges,2.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.1,20,,,percent of total billed charges,20% of total billed charges,2.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,80,,,case rate,80% for high cost drug carve out,8.93,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,8.93,
LIDOCAINE 5% PAT,3500505,CDM,250,RC,J3490,HCPCS,outpatient,,,18.75,9.38,,12.19,65,,,percent of total billed charges,65% of total billed charges,12.75,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.75,20,,,percent of total billed charges,20% of total billed charges,3.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.75,20,,,percent of total billed charges,20% of total billed charges,3.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.19,65,,,percent of total billed charges,65% of total billed charges,12.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.75,53.67,
LIDOCAINE HCL VISC 2% UD,3501072,CDM,250,RC,J3490,HCPCS,outpatient,,,5.4,2.7,,3.51,65,,,percent of total billed charges,65% of total billed charges,3.67,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.08,20,,,percent of total billed charges,20% of total billed charges,1.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.08,20,,,percent of total billed charges,20% of total billed charges,1.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.51,65,,,percent of total billed charges,65% of total billed charges,3.51,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.08,53.67,
LIDOCAINE INJ SYR [100 MG,3500506,CDM,636,RC,J2001,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
LIDOCAINE(2%) W/ EPINEPHRINE 1:100 INJ,3501107,CDM,636,RC,J3490,HCPCS,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,3.4,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,80,,,case rate,80% for high cost drug carve out,4.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,4.25,
LIDOCAINE/EPINEPHRINE 1-0,3501074,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LIFE PK8 W/ELECTRODE,3020037,CDM,730,RC,93041,HCPCS,outpatient,,,157,78.5,,102.05,65,,,percent of total billed charges,65% of total billed charges,106.76,68,,,percent of total billed charges,68% of total billed charges,11.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.4,20,,,percent of total billed charges,20% of total billed charges,31.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.4,20,,,percent of total billed charges,20% of total billed charges,31.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.05,65,,,percent of total billed charges,65% of total billed charges,102.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.79,148,
LIGATION OF HEMORRHOID BY RUBBER BAND,3462011,CDM,982,RC,46221,HCPCS,outpatient,,,364,182,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,132.13,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.12,110,,,fee schedule,110% of Medicare physician fee schedule,214.12,110,,,fee schedule,110% of Medicare physician fee schedule,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,223.85,115,,,fee schedule,115% of Medicare physician fee schedule,184.73,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,246.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.13,246.23,
LIGATOR BAND,3060165,CDM,272,RC,,,outpatient,,,850,425,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170,20,,,percent of total billed charges,20% of total billed charges,170,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170,20,,,percent of total billed charges,20% of total billed charges,170,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,552.5,65,,,percent of total billed charges,65% of total billed charges,552.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,552.5,
LINEZOLID/D5W PREMIX [600,3500507,CDM,636,RC,J2020,HCPCS,outpatient,,,25.6,12.8,,,,,,other,Not reimbursable per contract ,17.41,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.12,20,,,percent of total billed charges,20% of total billed charges,5.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.12,20,,,percent of total billed charges,20% of total billed charges,5.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.48,80,,,case rate,80% for high cost drug carve out,21.76,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.12,21.76,
LIPASE,3300163,CDM,301,RC,83690,HCPCS,outpatient,,,38.5,19.25,,25.03,65,,,percent of total billed charges,65% of total billed charges,26.18,68,,,percent of total billed charges,68% of total billed charges,9.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.7,20,,,percent of total billed charges,20% of total billed charges,7.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.7,20,,,percent of total billed charges,20% of total billed charges,7.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.03,65,,,percent of total billed charges,65% of total billed charges,25.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.7,26.18,
LIPID PANEL,3300017,CDM,301,RC,80061,HCPCS,outpatient,,,121,60.5,,78.65,65,,,percent of total billed charges,65% of total billed charges,82.28,68,,,percent of total billed charges,68% of total billed charges,19.01,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.2,20,,,percent of total billed charges,20% of total billed charges,24.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.2,20,,,percent of total billed charges,20% of total billed charges,24.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.65,65,,,percent of total billed charges,65% of total billed charges,78.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.01,82.28,
LIPID/REFLEX,3300896,CDM,301,RC,80061,HCPCS,outpatient,,,121,60.5,,78.65,65,,,percent of total billed charges,65% of total billed charges,82.28,68,,,percent of total billed charges,68% of total billed charges,19.01,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.2,20,,,percent of total billed charges,20% of total billed charges,24.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.2,20,,,percent of total billed charges,20% of total billed charges,24.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.65,65,,,percent of total billed charges,65% of total billed charges,78.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.01,82.28,
LIPOSY 200ML IV,3520331,CDM,250,RC,,,outpatient,,,114.15,57.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.83,20,,,percent of total billed charges,20% of total billed charges,22.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.83,20,,,percent of total billed charges,20% of total billed charges,22.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.2,65,,,percent of total billed charges,65% of total billed charges,74.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.83,74.2,
LIPOSYN 500ML IV,3520003,CDM,258,RC,B5000,HCPCS,outpatient,,,181.8,90.9,,118.17,65,,,percent of total billed charges,65% of total billed charges,123.62,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.36,20,,,percent of total billed charges,20% of total billed charges,36.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.36,20,,,percent of total billed charges,20% of total billed charges,36.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,118.17,65,,,percent of total billed charges,65% of total billed charges,118.17,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,109.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.36,123.62,
LISINOPRIL TAB [10 MG],3500508,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LISINOPRIL TAB [20 MG],3500509,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LISINOPRIL TAB [40 MG],3500510,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LISINOPRIL TAB [5 MG],3500511,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LITHIUM,3300149,CDM,301,RC,80178,HCPCS,outpatient,,,53,26.5,,34.45,65,,,percent of total billed charges,65% of total billed charges,36.04,68,,,percent of total billed charges,68% of total billed charges,9.38,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.6,20,,,percent of total billed charges,20% of total billed charges,10.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.6,20,,,percent of total billed charges,20% of total billed charges,10.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.45,65,,,percent of total billed charges,65% of total billed charges,34.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.38,36.04,
LITHIUM CAP [300 MG],3500512,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
LITHIUM CARBONATE CAP 150 MG,3501138,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LMA SIZE 2,6215887,CDM,272,RC,,,outpatient,,,83.6,41.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.72,20,,,percent of total billed charges,20% of total billed charges,16.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.72,20,,,percent of total billed charges,20% of total billed charges,16.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.34,65,,,percent of total billed charges,65% of total billed charges,54.34,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.72,54.34,
LMA SIZE 2.5,6215899,CDM,272,RC,,,outpatient,,,86,43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.9,65,,,percent of total billed charges,65% of total billed charges,55.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.2,55.9,
LMA SIZE 3,6215759,CDM,272,RC,,,outpatient,,,49.3,24.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.86,20,,,percent of total billed charges,20% of total billed charges,9.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.86,20,,,percent of total billed charges,20% of total billed charges,9.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.05,65,,,percent of total billed charges,65% of total billed charges,32.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.86,53.67,
LMA SIZE 4,6215758,CDM,272,RC,,,outpatient,,,52.3,26.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.46,20,,,percent of total billed charges,20% of total billed charges,10.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.46,20,,,percent of total billed charges,20% of total billed charges,10.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,65,,,percent of total billed charges,65% of total billed charges,34,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.46,53.67,
LMA SIZE 5,6215760,CDM,272,RC,,,outpatient,,,49.3,24.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.86,20,,,percent of total billed charges,20% of total billed charges,9.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.86,20,,,percent of total billed charges,20% of total billed charges,9.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.05,65,,,percent of total billed charges,65% of total billed charges,32.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.86,53.67,
LOCM 300-399MG/ML IOD 1ML,3400175,CDM,636,RC,Q9967,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,80,,,case rate,80% for high cost drug carve out,2.55,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,2.55,
LOCM 300-399MG/ML IOD1ML,3420085,CDM,636,RC,Q9967,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,80,,,case rate,80% for high cost drug carve out,2.55,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,2.55,
LONE STAR HOOKS,6215858,CDM,272,RC,,,outpatient,,,295.6,147.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.12,20,,,percent of total billed charges,20% of total billed charges,59.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.12,20,,,percent of total billed charges,20% of total billed charges,59.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192.14,65,,,percent of total billed charges,65% of total billed charges,192.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,192.14,
LONE STAR RETRACTOR,6215859,CDM,272,RC,,,outpatient,,,295.6,147.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.12,20,,,percent of total billed charges,20% of total billed charges,59.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.12,20,,,percent of total billed charges,20% of total billed charges,59.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192.14,65,,,percent of total billed charges,65% of total billed charges,192.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,192.14,
LOPERAMIDE CAP [2 MG],3500513,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LOPERAMIDE LIQ (1MG/5ML),3501078,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LORATADINE TAB [10 MG],3500515,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LORATIDINE LIQ [10 MG/10,3500516,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
LORAZEPAM INJ [2 MG/ML],3500517,CDM,636,RC,J2060,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
LORAZEPAM TAB [0.5 MG],3500518,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
LORAZEPAM TAB [1 MG],3500519,CDM,250,RC,J3490,HCPCS,outpatient,,,7.9,3.95,,5.14,65,,,percent of total billed charges,65% of total billed charges,5.37,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.58,20,,,percent of total billed charges,20% of total billed charges,1.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.58,20,,,percent of total billed charges,20% of total billed charges,1.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.14,65,,,percent of total billed charges,65% of total billed charges,5.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.58,53.67,
LOSARTAN  TAB [100 MG],3501047,CDM,250,RC,J3490,HCPCS,outpatient,,,15.4,7.7,,10.01,65,,,percent of total billed charges,65% of total billed charges,10.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.08,20,,,percent of total billed charges,20% of total billed charges,3.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.08,20,,,percent of total billed charges,20% of total billed charges,3.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.01,65,,,percent of total billed charges,65% of total billed charges,10.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,53.67,
LOSARTAN TAB [25 MG],3500971,CDM,250,RC,J3490,HCPCS,outpatient,,,8.4,4.2,,5.46,65,,,percent of total billed charges,65% of total billed charges,5.71,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.68,20,,,percent of total billed charges,20% of total billed charges,1.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.68,20,,,percent of total billed charges,20% of total billed charges,1.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.46,65,,,percent of total billed charges,65% of total billed charges,5.46,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.68,53.67,
LOSARTAN TAB [50 MG],3500520,CDM,250,RC,J3490,HCPCS,outpatient,,,11.25,5.63,,7.31,65,,,percent of total billed charges,65% of total billed charges,7.65,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.25,20,,,percent of total billed charges,20% of total billed charges,2.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.25,20,,,percent of total billed charges,20% of total billed charges,2.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.31,65,,,percent of total billed charges,65% of total billed charges,7.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,53.67,
LUBRICATING JELLY 2 OZ,6215862,CDM,271,RC,,,outpatient,,,15.3,7.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.06,20,,,percent of total billed charges,20% of total billed charges,3.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.06,20,,,percent of total billed charges,20% of total billed charges,3.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.95,65,,,percent of total billed charges,65% of total billed charges,9.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.06,53.67,
LUMBAR PUNCTURE,3020019,CDM,360,RC,62270,HCPCS,outpatient,,,280,140,,182,65,,,percent of total billed charges,65% of total billed charges,190.4,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,65,,,percent of total billed charges,65% of total billed charges,182,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,312,
LUMBAR PUNCTURE,3231115,CDM,450,RC,62270,HCPCS,outpatient,,,530,265,,344.5,65,,,percent of total billed charges,65% of total billed charges,360.4,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106,20,,,percent of total billed charges,20% of total billed charges,106,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106,20,,,percent of total billed charges,20% of total billed charges,106,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,344.5,65,,,percent of total billed charges,65% of total billed charges,344.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,360.4,
LUMBAR SP MIN:4 VIEW,3440137,CDM,972,RC,72110,HCPCS,outpatient,,,82.5,41.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.78,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.92,110,,,fee schedule,110% of Medicare physician fee schedule,54.92,110,,,fee schedule,110% of Medicare physician fee schedule,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,233.82,115,,,fee schedule,115% of Medicare physician fee schedule,79.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.78,100,,,fee schedule,100% of FL Medicaid fee schedule ,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.16,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,26.78,233.82,
LUMBAR SP MINI:4VIEW,3400046,CDM,320,RC,72110,HCPCS,outpatient,,,242,121,,157.3,65,,,percent of total billed charges,65% of total billed charges,164.56,68,,,percent of total billed charges,68% of total billed charges,30.67,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.4,20,,,percent of total billed charges,20% of total billed charges,48.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.4,20,,,percent of total billed charges,20% of total billed charges,48.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.3,65,,,percent of total billed charges,65% of total billed charges,157.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,145.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.67,180,
LUMBAR SPINE 2 VIEW,3400047,CDM,320,RC,72100,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,22.37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.37,180,
LUMBAR SPINE 2 VIEW,3440135,CDM,972,RC,72100,HCPCS,outpatient,,,62.7,31.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.91,110,,,fee schedule,110% of Medicare physician fee schedule,42.91,110,,,fee schedule,110% of Medicare physician fee schedule,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.26,115,,,fee schedule,115% of Medicare physician fee schedule,71.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.22,221.26,
LUPUS ANTICOAGULANT,3300657,CDM,305,RC,85705,HCPCS,outpatient,,,127,63.5,,82.55,65,,,percent of total billed charges,65% of total billed charges,86.36,68,,,percent of total billed charges,68% of total billed charges,11.05,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.4,20,,,percent of total billed charges,20% of total billed charges,25.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.4,20,,,percent of total billed charges,20% of total billed charges,25.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.55,65,,,percent of total billed charges,65% of total billed charges,82.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.05,86.36,
LUTEINIZING HORMONE,3300177,CDM,301,RC,83002,HCPCS,outpatient,,,87,43.5,,56.55,65,,,percent of total billed charges,65% of total billed charges,59.16,68,,,percent of total billed charges,68% of total billed charges,26.29,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.4,20,,,percent of total billed charges,20% of total billed charges,17.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.4,20,,,percent of total billed charges,20% of total billed charges,17.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.55,65,,,percent of total billed charges,65% of total billed charges,56.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.4,59.16,
LYME DISEASE TITER,3300503,CDM,302,RC,86618,HCPCS,outpatient,,,136,68,,88.4,65,,,percent of total billed charges,65% of total billed charges,92.48,68,,,percent of total billed charges,68% of total billed charges,20.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.2,20,,,percent of total billed charges,20% of total billed charges,27.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.2,20,,,percent of total billed charges,20% of total billed charges,27.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.4,65,,,percent of total billed charges,65% of total billed charges,88.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.82,92.48,
LYME DISEASE WESTERN,3300609,CDM,302,RC,86617,HCPCS,outpatient,,,122,61,,79.3,65,,,percent of total billed charges,65% of total billed charges,82.96,68,,,percent of total billed charges,68% of total billed charges,21.98,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.4,20,,,percent of total billed charges,20% of total billed charges,24.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.4,20,,,percent of total billed charges,20% of total billed charges,24.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.3,65,,,percent of total billed charges,65% of total billed charges,79.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,73.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.98,82.96,
MAG HYD/ AL HYD/ SIM SUSP,3500521,CDM,250,RC,J3490,HCPCS,outpatient,,,19,9.5,,12.35,65,,,percent of total billed charges,65% of total billed charges,12.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.8,20,,,percent of total billed charges,20% of total billed charges,3.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.8,20,,,percent of total billed charges,20% of total billed charges,3.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.35,65,,,percent of total billed charges,65% of total billed charges,12.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.8,53.67,
MAGNESIUM,3300077,CDM,301,RC,83735,HCPCS,outpatient,,,50,25,,32.5,65,,,percent of total billed charges,65% of total billed charges,34,68,,,percent of total billed charges,68% of total billed charges,9.51,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.51,34,
MAGNESIUM CITRATE SOL,3500522,CDM,250,RC,J3490,HCPCS,outpatient,,,10.5,5.25,,6.83,65,,,percent of total billed charges,65% of total billed charges,7.14,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.1,20,,,percent of total billed charges,20% of total billed charges,2.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.1,20,,,percent of total billed charges,20% of total billed charges,2.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.83,65,,,percent of total billed charges,65% of total billed charges,6.83,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,53.67,
MAGNESIUM OXIDE TAB [400,3500523,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
MAGNESIUM SULF INJ [1 GM/,3500524,CDM,636,RC,J3475,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MAGNESIUM SULF PREMIX  [2,3500959,CDM,250,RC,,,outpatient,,,78.75,39.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.75,20,,,percent of total billed charges,20% of total billed charges,15.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.75,20,,,percent of total billed charges,20% of total billed charges,15.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.19,65,,,percent of total billed charges,65% of total billed charges,51.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.75,53.67,
MALARIA SMEAR,3300743,CDM,306,RC,87207,HCPCS,outpatient,,,52,26,,33.8,65,,,percent of total billed charges,65% of total billed charges,35.36,68,,,percent of total billed charges,68% of total billed charges,8.5,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.5,35.36,
MAMMO DIAG,3440141,CDM,972,RC,77066,HCPCS,outpatient,,,80,40,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,88,110,,,fee schedule,110% of Medicare physician fee schedule,88,110,,,fee schedule,110% of Medicare physician fee schedule,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,181.18,115,,,fee schedule,115% of Medicare physician fee schedule,138.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85.71,181.18,
MAMMO/UNILATERAL/RT,3400221,CDM,401,RC,77065,HCPCS,outpatient,,,125,62.5,,81.25,65,,,percent of total billed charges,65% of total billed charges,85,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,20,,,percent of total billed charges,20% of total billed charges,25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,20,,,percent of total billed charges,20% of total billed charges,25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.25,65,,,percent of total billed charges,65% of total billed charges,81.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25,91,
MAMO BIL SCRN TO DX,3400138,CDM,401,RC,77067,HCPCS,outpatient,,,166,83,,107.9,65,,,percent of total billed charges,65% of total billed charges,112.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.2,20,,,percent of total billed charges,20% of total billed charges,33.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.2,20,,,percent of total billed charges,20% of total billed charges,33.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,107.9,65,,,percent of total billed charges,65% of total billed charges,107.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.2,112.88,
MAMO BIL SCRN TO DX,3440415,CDM,972,RC,77067,HCPCS,outpatient,,,68,34,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.25,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.8,110,,,fee schedule,110% of Medicare physician fee schedule,74.8,110,,,fee schedule,110% of Medicare physician fee schedule,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,167.38,115,,,fee schedule,115% of Medicare physician fee schedule,122.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.25,167.38,
MAMO UNI L SCN TO DX,3400139,CDM,401,RC,77065,HCPCS,outpatient,,,155,77.5,,100.75,65,,,percent of total billed charges,65% of total billed charges,105.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31,20,,,percent of total billed charges,20% of total billed charges,31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31,20,,,percent of total billed charges,20% of total billed charges,31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.75,65,,,percent of total billed charges,65% of total billed charges,100.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31,105.4,
MAMO UNI L SCN TO DX,3440417,CDM,972,RC,77065,HCPCS,outpatient,,,62,31,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.2,110,,,fee schedule,110% of Medicare physician fee schedule,68.2,110,,,fee schedule,110% of Medicare physician fee schedule,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,160.48,115,,,fee schedule,115% of Medicare physician fee schedule,120.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.45,160.48,
MAMO UNI R SCN TO DX,3440419,CDM,972,RC,77065,HCPCS,outpatient,,,62,31,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.2,110,,,fee schedule,110% of Medicare physician fee schedule,68.2,110,,,fee schedule,110% of Medicare physician fee schedule,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,160.48,115,,,fee schedule,115% of Medicare physician fee schedule,120.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.45,160.48,
MAMO UNI R SRN TO DX,3400140,CDM,401,RC,77065,HCPCS,outpatient,,,155,77.5,,100.75,65,,,percent of total billed charges,65% of total billed charges,105.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31,20,,,percent of total billed charges,20% of total billed charges,31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31,20,,,percent of total billed charges,20% of total billed charges,31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.75,65,,,percent of total billed charges,65% of total billed charges,100.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31,105.4,
MAMO-BIL  SCREENING,3440143,CDM,972,RC,77067,HCPCS,outpatient,,,68,34,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.25,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.8,110,,,fee schedule,110% of Medicare physician fee schedule,74.8,110,,,fee schedule,110% of Medicare physician fee schedule,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,167.38,115,,,fee schedule,115% of Medicare physician fee schedule,122.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,86.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.25,167.38,
MAMO-BILATERAL DIAG,3400136,CDM,401,RC,77066,HCPCS,outpatient,,,245,122.5,,159.25,65,,,percent of total billed charges,65% of total billed charges,166.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49,20,,,percent of total billed charges,20% of total billed charges,49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49,20,,,percent of total billed charges,20% of total billed charges,49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.25,65,,,percent of total billed charges,65% of total billed charges,159.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49,166.6,
MAMO-BILATERAL SCREE,3400170,CDM,403,RC,77067,HCPCS,outpatient,,,240,120,,156,65,,,percent of total billed charges,65% of total billed charges,163.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,20,,,percent of total billed charges,20% of total billed charges,48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,20,,,percent of total billed charges,20% of total billed charges,48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156,65,,,percent of total billed charges,65% of total billed charges,156,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,144,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,163.2,
MAMO/UNILATERAL LT,3440147,CDM,972,RC,77065,HCPCS,outpatient,,,62,31,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.2,110,,,fee schedule,110% of Medicare physician fee schedule,68.2,110,,,fee schedule,110% of Medicare physician fee schedule,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,160.48,115,,,fee schedule,115% of Medicare physician fee schedule,120.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.45,160.48,
MAMO/UNILATERAL RT,3440139,CDM,972,RC,77065,HCPCS,outpatient,,,62,31,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.2,110,,,fee schedule,110% of Medicare physician fee schedule,68.2,110,,,fee schedule,110% of Medicare physician fee schedule,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,160.48,115,,,fee schedule,115% of Medicare physician fee schedule,120.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.45,160.48,
MAMO/UNILATERAL-L,3400135,CDM,401,RC,77065,HCPCS,outpatient,,,125,62.5,,81.25,65,,,percent of total billed charges,65% of total billed charges,85,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,20,,,percent of total billed charges,20% of total billed charges,25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,20,,,percent of total billed charges,20% of total billed charges,25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.25,65,,,percent of total billed charges,65% of total billed charges,81.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25,91,
MANDIBLE MIN 4 V,3440149,CDM,972,RC,70110,HCPCS,outpatient,,,68.2,34.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.77,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.49,110,,,fee schedule,110% of Medicare physician fee schedule,46.49,110,,,fee schedule,110% of Medicare physician fee schedule,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,225,115,,,fee schedule,115% of Medicare physician fee schedule,73.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.77,225,
MANDIBLE MIN 4 VIEW,3400031,CDM,320,RC,70110,HCPCS,outpatient,,,204,102,,132.6,65,,,percent of total billed charges,65% of total billed charges,138.72,68,,,percent of total billed charges,68% of total billed charges,20.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,65,,,percent of total billed charges,65% of total billed charges,132.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.77,180,
MANNITOL 20% PREMIX INJ [,3500526,CDM,636,RC,J2150,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MANUAL DIFFERENTIAL,3300677,CDM,305,RC,85007,HCPCS,outpatient,,,30,15,,19.5,65,,,percent of total billed charges,65% of total billed charges,20.4,68,,,percent of total billed charges,68% of total billed charges,4.89,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,20.4,
MANUAL THERAPY,3600094,CDM,420,RC,97140,HCPCS,outpatient,,,110,55,,71.5,65,,,percent of total billed charges,65% of total billed charges,74.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.5,65,,,percent of total billed charges,65% of total billed charges,71.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22,82,
MANUAL THERAPY/15M,3600021,CDM,420,RC,97140,HCPCS,outpatient,,,118,59,,76.7,65,,,percent of total billed charges,65% of total billed charges,80.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.6,20,,,percent of total billed charges,20% of total billed charges,23.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.6,20,,,percent of total billed charges,20% of total billed charges,23.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.7,65,,,percent of total billed charges,65% of total billed charges,76.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.6,82,
MAPLESON CIRCUIT KIT,6215852,CDM,272,RC,,,outpatient,,,171.9,85.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.38,20,,,percent of total billed charges,20% of total billed charges,34.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.38,20,,,percent of total billed charges,20% of total billed charges,34.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111.74,65,,,percent of total billed charges,65% of total billed charges,111.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.38,111.74,
MARYLAND FUSION,6215831,CDM,272,RC,,,outpatient,,,220,110,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44,143,
MECLIZINE TAB [12.5 MG],3500527,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MECLIZINE TAB [25 MG],3500528,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MED CLIP APPLIER,6215802,CDM,272,RC,,,outpatient,,,530.82,265.41,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.16,20,,,percent of total billed charges,20% of total billed charges,106.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.16,20,,,percent of total billed charges,20% of total billed charges,106.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,345.03,65,,,percent of total billed charges,65% of total billed charges,345.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,318.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,345.03,
MED NON-VENTED BIPAP/CPAP MASK,3170111,CDM,272,RC,,,outpatient,,,154.28,77.14,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.86,20,,,percent of total billed charges,20% of total billed charges,30.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.86,20,,,percent of total billed charges,20% of total billed charges,30.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.28,65,,,percent of total billed charges,65% of total billed charges,100.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.86,100.28,
MED- EPINEPHRINE,3700219,CDM,636,RC,J1070,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-ATROPINE 1 MG,3700221,CDM,636,RC,J0461,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-BENADRYL 50MG,3700225,CDM,636,RC,J1200,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-CARRAKLENZ 1 OZ,3700001,CDM,250,RC,,,outpatient,,,4.85,2.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.97,20,,,percent of total billed charges,20% of total billed charges,0.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.97,20,,,percent of total billed charges,20% of total billed charges,0.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.15,65,,,percent of total billed charges,65% of total billed charges,3.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.97,53.67,
MED-CARRASYN 1/2 OZ,3700003,CDM,250,RC,,,outpatient,,,12.95,6.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.59,20,,,percent of total billed charges,20% of total billed charges,2.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.59,20,,,percent of total billed charges,20% of total billed charges,2.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.42,65,,,percent of total billed charges,65% of total billed charges,8.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.59,53.67,
MED-CLONIDINE .1MG,3700259,CDM,637,RC,,,outpatient,,,2.25,1.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.45,20,,,percent of total billed charges,20% of total billed charges,0.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.45,20,,,percent of total billed charges,20% of total billed charges,0.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.46,65,,,percent of total billed charges,65% of total billed charges,1.46,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.45,53.67,
MED-DECADRON 4MG,3700235,CDM,636,RC,J1100,HCPCS,outpatient,,,20,10,,,,,,other,Not reimbursable per contract ,13.6,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,80,,,case rate,80% for high cost drug carve out,17,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,17,
MED-DEPOMEDRL 40MG X,3700229,CDM,636,RC,J1030,HCPCS,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,10.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.8,80,,,case rate,80% for high cost drug carve out,13.6,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.2,13.6,
MED-DEPOMEDROL 120MG,3700241,CDM,636,RC,J1030,HCPCS,outpatient,,,34,17,,,,,,other,Not reimbursable per contract ,23.12,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.2,80,,,case rate,80% for high cost drug carve out,28.9,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.8,28.9,
MED-DEPOMEDROL 80MG,3700215,CDM,636,RC,J1040,HCPCS,outpatient,,,31,15.5,,,,,,other,Not reimbursable per contract ,21.08,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.8,80,,,case rate,80% for high cost drug carve out,26.35,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.2,26.35,
MED-DILANTIN 50MG,3700223,CDM,636,RC,J1165,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-GI COCKTAIL,3700257,CDM,637,RC,,,outpatient,,,15,7.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,53.67,
MED-INFLUENZA 3 YRS OR >,3700207,CDM,636,RC,90658,HCPCS,outpatient,,,15,7.5,,9.75,65,,,percent of total billed charges,65% of total billed charges,10.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,80,,,case rate,80% for high cost drug carve out,12.75,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,12.75,
MED-INSULIN,3700255,CDM,637,RC,J1815,HCPCS,outpatient,,,12,6,,7.8,65,,,percent of total billed charges,65% of total billed charges,8.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.8,65,,,percent of total billed charges,65% of total billed charges,7.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,53.67,
MED-KENALOG 40MG/ML,3700247,CDM,636,RC,J3301,HCPCS,outpatient,,,21,10.5,,,,,,other,Not reimbursable per contract ,14.28,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,80,,,case rate,80% for high cost drug carve out,17.85,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,17.85,
MED-LASIX ALL MG,3700209,CDM,636,RC,J1940,HCPCS,outpatient,,,20,10,,,,,,other,Not reimbursable per contract ,13.6,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,80,,,case rate,80% for high cost drug carve out,17,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,17,
MED-NARCAN 0.4MG,3700227,CDM,636,RC,J2310,HCPCS,outpatient,,,22,11,,,,,,other,Not reimbursable per contract ,14.96,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,80,,,case rate,80% for high cost drug carve out,18.7,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,18.7,
MED-PHENEGRAN 25MG,3700211,CDM,636,RC,J2950,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-ROCEPHIN 250MG X,3700231,CDM,636,RC,J0696,HCPCS,outpatient,,,22,11,,,,,,other,Not reimbursable per contract ,14.96,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,80,,,case rate,80% for high cost drug carve out,18.7,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,18.7,
MED-SOLUCORTEF 100MG,3700253,CDM,636,RC,J1720,HCPCS,outpatient,,,15,7.5,,,,,,other,Not reimbursable per contract ,10.2,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,80,,,case rate,80% for high cost drug carve out,12.75,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,12.75,
MED-SOLUMEDROL 125 MG,3700249,CDM,636,RC,J2930,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-SOLUMEDROL 40MG,3700251,CDM,636,RC,J2920,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,4,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-TETANUS TOX,3700217,CDM,636,RC,90703,HCPCS,outpatient,,,12,6,,7.8,65,,,percent of total billed charges,65% of total billed charges,8.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-TORADOL 15 MG,3700239,CDM,636,RC,J1885,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-TORADOL 30 MG,3700237,CDM,636,RC,J1885,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MED-VIT B12 OUR MED,3700233,CDM,636,RC,J3420,HCPCS,outpatient,,,12,6,,,,,,other,Not reimbursable per contract ,8.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,80,,,case rate,80% for high cost drug carve out,10.2,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,10.2,
MEDI HONEY DRESSING 4X5,6210238,CDM,272,RC,,,outpatient,,,84.05,42.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.81,20,,,percent of total billed charges,20% of total billed charges,16.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.81,20,,,percent of total billed charges,20% of total billed charges,16.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.63,65,,,percent of total billed charges,65% of total billed charges,54.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.81,54.63,
"MEDI HONEY PASTE 1.5 OZ, TUBE",6210237,CDM,272,RC,,,outpatient,,,143.06,71.53,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.61,20,,,percent of total billed charges,20% of total billed charges,28.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.61,20,,,percent of total billed charges,20% of total billed charges,28.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.99,65,,,percent of total billed charges,65% of total billed charges,92.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.61,92.99,
MEDICO PASTE/UNA BOO,3250099,CDM,271,RC,,,outpatient,,,52.85,26.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.57,20,,,percent of total billed charges,20% of total billed charges,10.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.57,20,,,percent of total billed charges,20% of total billed charges,10.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.35,65,,,percent of total billed charges,65% of total billed charges,34.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.57,53.67,
MEDIHONEY 2X2,6215882,CDM,272,RC,,,outpatient,,,49.9,24.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.98,20,,,percent of total billed charges,20% of total billed charges,9.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.98,20,,,percent of total billed charges,20% of total billed charges,9.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.44,65,,,percent of total billed charges,65% of total billed charges,32.44,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.98,53.67,
MEDROXYPROGESTONE TAB [10,3500530,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MEGESTROL SUSP [40 MG/ML,3500532,CDM,250,RC,J3490,HCPCS,outpatient,,,22.65,11.33,,14.72,65,,,percent of total billed charges,65% of total billed charges,15.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.53,20,,,percent of total billed charges,20% of total billed charges,4.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.53,20,,,percent of total billed charges,20% of total billed charges,4.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.72,65,,,percent of total billed charges,65% of total billed charges,14.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.53,53.67,
MEGESTROL TAB [40 MG],3500533,CDM,250,RC,J3490,HCPCS,outpatient,,,6.85,3.43,,4.45,65,,,percent of total billed charges,65% of total billed charges,4.66,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.37,20,,,percent of total billed charges,20% of total billed charges,1.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.37,20,,,percent of total billed charges,20% of total billed charges,1.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.45,65,,,percent of total billed charges,65% of total billed charges,4.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.37,53.67,
MELATONIN TAB [3 MG],3501055,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MELOXICAM TAB [15 MG],3500534,CDM,250,RC,J3490,HCPCS,outpatient,,,23.35,11.68,,15.18,65,,,percent of total billed charges,65% of total billed charges,15.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.67,20,,,percent of total billed charges,20% of total billed charges,4.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.67,20,,,percent of total billed charges,20% of total billed charges,4.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.18,65,,,percent of total billed charges,65% of total billed charges,15.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.67,53.67,
MELOXICAM TAB [7.5 MG],3500535,CDM,250,RC,J3490,HCPCS,outpatient,,,15.5,7.75,,10.08,65,,,percent of total billed charges,65% of total billed charges,10.54,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.08,65,,,percent of total billed charges,65% of total billed charges,10.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.1,53.67,
MEMANTINE TAB [10 MG],3500536,CDM,250,RC,J3490,HCPCS,outpatient,,,44.45,22.23,,28.89,65,,,percent of total billed charges,65% of total billed charges,30.23,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.89,20,,,percent of total billed charges,20% of total billed charges,8.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.89,20,,,percent of total billed charges,20% of total billed charges,8.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.89,65,,,percent of total billed charges,65% of total billed charges,28.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.89,53.67,
MEMANTINE TAB [5 MG],3500537,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MENTHOL/ CAMPHOR LOT,3500538,CDM,250,RC,J3490,HCPCS,outpatient,,,9.1,4.55,,5.92,65,,,percent of total billed charges,65% of total billed charges,6.19,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.82,20,,,percent of total billed charges,20% of total billed charges,1.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.82,20,,,percent of total billed charges,20% of total billed charges,1.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.92,65,,,percent of total billed charges,65% of total billed charges,5.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,53.67,
MEPILEX  9X9 HEEL,3250640,CDM,272,RC,,,outpatient,,,57.75,28.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.55,20,,,percent of total billed charges,20% of total billed charges,11.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.55,20,,,percent of total billed charges,20% of total billed charges,11.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.54,65,,,percent of total billed charges,65% of total billed charges,37.54,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,53.67,
MEPILEX 4X12,3250635,CDM,272,RC,,,outpatient,,,30.54,15.27,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.11,20,,,percent of total billed charges,20% of total billed charges,6.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.11,20,,,percent of total billed charges,20% of total billed charges,6.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.85,65,,,percent of total billed charges,65% of total billed charges,19.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.11,53.67,
MEPILEX AG 3X3,3521986,CDM,272,RC,,,outpatient,,,68.3,34.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.66,20,,,percent of total billed charges,20% of total billed charges,13.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.66,20,,,percent of total billed charges,20% of total billed charges,13.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.4,65,,,percent of total billed charges,65% of total billed charges,44.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.66,53.67,
MEPILEX AG 4X4,3521945,CDM,272,RC,,,outpatient,,,67.56,33.78,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.51,20,,,percent of total billed charges,20% of total billed charges,13.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.51,20,,,percent of total billed charges,20% of total billed charges,13.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.91,65,,,percent of total billed charges,65% of total billed charges,43.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.51,53.67,
MEPILEX BORDER 7X7,3250638,CDM,272,RC,,,outpatient,,,64.2,32.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.84,20,,,percent of total billed charges,20% of total billed charges,12.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.84,20,,,percent of total billed charges,20% of total billed charges,12.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.73,65,,,percent of total billed charges,65% of total billed charges,41.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.84,53.67,
MEPILEX BORDER 9X9,3250636,CDM,272,RC,,,outpatient,,,84,42,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,54.6,
MEPILEX DRES  4X4,3250633,CDM,272,RC,,,outpatient,,,17.86,8.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.57,20,,,percent of total billed charges,20% of total billed charges,3.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.57,20,,,percent of total billed charges,20% of total billed charges,3.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.61,65,,,percent of total billed charges,65% of total billed charges,11.61,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.57,53.67,
MEPILEX DRES 3X3 CARTON 5,3250632,CDM,272,RC,,,outpatient,,,13.12,6.56,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.62,20,,,percent of total billed charges,20% of total billed charges,2.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.62,20,,,percent of total billed charges,20% of total billed charges,2.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.53,65,,,percent of total billed charges,65% of total billed charges,8.53,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,53.67,
MEPILEX HEEL 5X8,3250700,CDM,272,RC,,,outpatient,,,78.5,39.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.7,20,,,percent of total billed charges,20% of total billed charges,15.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.7,20,,,percent of total billed charges,20% of total billed charges,15.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.03,65,,,percent of total billed charges,65% of total billed charges,51.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.7,53.67,
MEPITEL ONE DRESSING 2X3,3250639,CDM,272,RC,,,outpatient,,,3.75,1.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.75,20,,,percent of total billed charges,20% of total billed charges,0.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.75,20,,,percent of total billed charges,20% of total billed charges,0.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.44,65,,,percent of total billed charges,65% of total billed charges,2.44,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.75,53.67,
MERCURY,3300137,CDM,301,RC,83825,HCPCS,outpatient,,,97,48.5,,63.05,65,,,percent of total billed charges,65% of total billed charges,65.96,68,,,percent of total billed charges,68% of total billed charges,23.07,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.05,65,,,percent of total billed charges,65% of total billed charges,63.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.4,65.96,
MEROPENEM  500MG,3521954,CDM,636,RC,J2185,HCPCS,outpatient,,,63,31.5,,,,,,other,Not reimbursable per contract ,42.84,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,80,,,case rate,80% for high cost drug carve out,53.55,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,53.55,
MEROPENEM 1G/VIAL,3501268,CDM,636,RC,J2185,HCPCS,outpatient,,,520,260,,338,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,353.6,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104,20,,,percent of total billed charges,20% of total billed charges,104,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104,20,,,percent of total billed charges,20% of total billed charges,104,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,416,80,,,case rate,80% for high cost drug carve out,442,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,312,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104,442,
MESH LG LEFT,6215782,CDM,278,RC,,,both,,,733.42,366.71,,,,,,other,Not reimbursable per contract ,498.73,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.68,20,,,percent of total billed charges,20% of total billed charges,146.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.68,20,,,percent of total billed charges,20% of total billed charges,146.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,586.74,80,,,case rate,80% for implant carve out,623.41,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,623.41,
"MESH, HERNIA MD 4 1/2",6215787,CDM,278,RC,,,both,,,2466.8,1233.4,,,,,,other,Not reimbursable per contract ,1677.43,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,493.36,20,,,percent of total billed charges,20% of total billed charges,493.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,493.36,20,,,percent of total billed charges,20% of total billed charges,493.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1973.44,80,,,case rate,80% for implant carve out,2096.78,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1480.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,2096.78,
"MESH, HERNIA UMB 20X15",6215788,CDM,278,RC,,,both,,,2126.58,1063.29,,,,,,other,Not reimbursable per contract ,1446.08,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,425.32,20,,,percent of total billed charges,20% of total billed charges,425.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,425.32,20,,,percent of total billed charges,20% of total billed charges,425.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1701.26,80,,,case rate,80% for implant carve out,1807.59,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1275.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1807.59,
"MESH, HERNIA UMB 30X20",6215789,CDM,278,RC,,,both,,,3619.72,1809.86,,,,,,other,Not reimbursable per contract ,2461.41,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,723.94,20,,,percent of total billed charges,20% of total billed charges,723.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,723.94,20,,,percent of total billed charges,20% of total billed charges,723.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2895.78,80,,,case rate,80% for implant carve out,3076.76,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2171.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,3076.76,
"MESH, LEFT MED",6215783,CDM,278,RC,,,both,,,681.33,340.67,,,,,,other,Not reimbursable per contract ,463.31,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.27,20,,,percent of total billed charges,20% of total billed charges,136.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.27,20,,,percent of total billed charges,20% of total billed charges,136.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,545.06,80,,,case rate,80% for implant carve out,579.13,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,579.13,
"MESH, MARLEX 1X4",6215786,CDM,278,RC,,,both,,,247.82,123.91,,,,,,other,Not reimbursable per contract ,168.52,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.56,20,,,percent of total billed charges,20% of total billed charges,49.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.56,20,,,percent of total billed charges,20% of total billed charges,49.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,198.26,80,,,case rate,80% for implant carve out,210.65,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.56,210.65,
"MESH, MED RIGHT",6215784,CDM,278,RC,,,both,,,681.33,340.67,,,,,,other,Not reimbursable per contract ,463.31,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.27,20,,,percent of total billed charges,20% of total billed charges,136.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.27,20,,,percent of total billed charges,20% of total billed charges,136.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,545.06,80,,,case rate,80% for implant carve out,579.13,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,579.13,
"MESH, PROLENE 6""X6""",6215872,CDM,278,RC,,,both,,,681.5,340.75,,,,,,other,Not reimbursable per contract ,463.42,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.3,20,,,percent of total billed charges,20% of total billed charges,136.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.3,20,,,percent of total billed charges,20% of total billed charges,136.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,545.2,80,,,case rate,80% for implant carve out,579.28,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,408.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,579.28,
"MESH, RT LRG",6215785,CDM,278,RC,,,both,,,733.42,366.71,,,,,,other,Not reimbursable per contract ,498.73,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.68,20,,,percent of total billed charges,20% of total billed charges,146.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.68,20,,,percent of total billed charges,20% of total billed charges,146.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,586.74,80,,,case rate,80% for implant carve out,623.41,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,623.41,
METANEPHRINES,3300247,CDM,301,RC,83835,HCPCS,outpatient,,,87,43.5,,56.55,65,,,percent of total billed charges,65% of total billed charges,59.16,68,,,percent of total billed charges,68% of total billed charges,24.05,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.4,20,,,percent of total billed charges,20% of total billed charges,17.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.4,20,,,percent of total billed charges,20% of total billed charges,17.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.55,65,,,percent of total billed charges,65% of total billed charges,56.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.4,59.16,
METFORMIN TAB [1000 MG],3500542,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METFORMIN TAB [500 MG],3500543,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METHADONE TAB [10 MG],3500545,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
METHIMAZOLE TAB [5 MG],3500546,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METHOCARBAMOL TAB [500 MG,3500547,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METHOCARBAMOL TAB [750 MG,3500548,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METHOTREXATE TAB [2.5 MG],3500549,CDM,250,RC,J8610,HCPCS,outpatient,,,31.2,15.6,,20.28,65,,,percent of total billed charges,65% of total billed charges,21.22,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.24,20,,,percent of total billed charges,20% of total billed charges,6.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.24,20,,,percent of total billed charges,20% of total billed charges,6.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.28,65,,,percent of total billed charges,65% of total billed charges,20.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.24,53.67,
METHYLCELLULOSE POWD,3500550,CDM,250,RC,J3490,HCPCS,outpatient,,,78.1,39.05,,50.77,65,,,percent of total billed charges,65% of total billed charges,53.11,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.62,20,,,percent of total billed charges,20% of total billed charges,15.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.62,20,,,percent of total billed charges,20% of total billed charges,15.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.77,65,,,percent of total billed charges,65% of total billed charges,50.77,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.62,53.67,
METHYLCELLULOSE TAB [500,3500551,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
"METHYLMALONIC ACID, SERUM",3300792,CDM,309,RC,83921,HCPCS,outpatient,,,195,97.5,,126.75,65,,,percent of total billed charges,65% of total billed charges,132.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.75,65,,,percent of total billed charges,65% of total billed charges,126.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,132.6,
"METHYLMALONIC ACID, URINE",3300794,CDM,309,RC,83921,HCPCS,outpatient,,,195,97.5,,126.75,65,,,percent of total billed charges,65% of total billed charges,132.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,20,,,percent of total billed charges,20% of total billed charges,39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.75,65,,,percent of total billed charges,65% of total billed charges,126.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,117,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,132.6,
METHYLPREDNISOLONE INJ [4,3500554,CDM,636,RC,J2920,HCPCS,outpatient,,,32.5,16.25,,,,,,other,Not reimbursable per contract ,22.1,68,,,case rate,68% of high cost drug carve out,4,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.5,20,,,percent of total billed charges,20% of total billed charges,6.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.5,20,,,percent of total billed charges,20% of total billed charges,6.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,80,,,case rate,80% for high cost drug carve out,27.63,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,27.63,
METHYLPREDNISOLONE INJ [4,3500556,CDM,636,RC,J1030,HCPCS,outpatient,,,99.05,49.53,,,,,,other,Not reimbursable per contract ,67.35,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.81,20,,,percent of total billed charges,20% of total billed charges,19.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.81,20,,,percent of total billed charges,20% of total billed charges,19.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.24,80,,,case rate,80% for high cost drug carve out,84.19,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.81,84.19,
METHYLPREDNISOLONE INJ [8,3500555,CDM,636,RC,J1040,HCPCS,outpatient,,,99.05,49.53,,,,,,other,Not reimbursable per contract ,67.35,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.81,20,,,percent of total billed charges,20% of total billed charges,19.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.81,20,,,percent of total billed charges,20% of total billed charges,19.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.24,80,,,case rate,80% for high cost drug carve out,84.19,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.81,84.19,
METHYLPREDNISOLONE TAB [4,3500557,CDM,250,RC,J7509,HCPCS,outpatient,,,8.25,4.13,,5.36,65,,,percent of total billed charges,65% of total billed charges,5.61,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.65,20,,,percent of total billed charges,20% of total billed charges,1.65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.65,20,,,percent of total billed charges,20% of total billed charges,1.65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.36,65,,,percent of total billed charges,65% of total billed charges,5.36,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,53.67,
METOCLOPRAMIDE INJ [5 MG/,3500558,CDM,636,RC,J2765,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
METOCLOPRAMIDE LIQ [5 MG/,3500559,CDM,250,RC,J3490,HCPCS,outpatient,,,11.15,5.58,,7.25,65,,,percent of total billed charges,65% of total billed charges,7.58,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.23,20,,,percent of total billed charges,20% of total billed charges,2.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.23,20,,,percent of total billed charges,20% of total billed charges,2.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.25,65,,,percent of total billed charges,65% of total billed charges,7.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.23,53.67,
METOCLOPRAMIDE TAB [10 MG,3500560,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METOCLOPRAMIDE TAB [5 MG],3500561,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METOLAZONE TAB [5 MG],3500563,CDM,250,RC,J3490,HCPCS,outpatient,,,11.8,5.9,,7.67,65,,,percent of total billed charges,65% of total billed charges,8.02,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.36,20,,,percent of total billed charges,20% of total billed charges,2.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.36,20,,,percent of total billed charges,20% of total billed charges,2.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.67,65,,,percent of total billed charges,65% of total billed charges,7.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.36,53.67,
METOPROLOL INJ [5 MG/5 ML,3500564,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
METOPROLOL SUCC ER TAB [1,3500565,CDM,250,RC,J3490,HCPCS,outpatient,,,9.35,4.68,,6.08,65,,,percent of total billed charges,65% of total billed charges,6.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.87,20,,,percent of total billed charges,20% of total billed charges,1.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.87,20,,,percent of total billed charges,20% of total billed charges,1.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.08,65,,,percent of total billed charges,65% of total billed charges,6.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.87,53.67,
METOPROLOL SUCC ER TAB [2,3500566,CDM,250,RC,J3490,HCPCS,outpatient,,,6.2,3.1,,4.03,65,,,percent of total billed charges,65% of total billed charges,4.22,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.24,20,,,percent of total billed charges,20% of total billed charges,1.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.24,20,,,percent of total billed charges,20% of total billed charges,1.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.03,65,,,percent of total billed charges,65% of total billed charges,4.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.24,53.67,
METOPROLOL SUCC ER TAB [5,3500567,CDM,250,RC,J3490,HCPCS,outpatient,,,6.2,3.1,,4.03,65,,,percent of total billed charges,65% of total billed charges,4.22,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.24,20,,,percent of total billed charges,20% of total billed charges,1.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.24,20,,,percent of total billed charges,20% of total billed charges,1.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.03,65,,,percent of total billed charges,65% of total billed charges,4.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.24,53.67,
METOPROLOL TAR TAB [25 MG,3500568,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METOPROLOL TAR TAB [50 MG,3500569,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METRONIDAZOLE TAB [250 MG,3500570,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METRONIDAZOLE TAB [500 MG,3500571,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
METRONIDAZOLE/ SOD CL PRE,3500572,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MHA-TP,3300005,CDM,300,RC,86780,HCPCS,outpatient,,,73,36.5,,47.45,65,,,percent of total billed charges,65% of total billed charges,49.64,68,,,percent of total billed charges,68% of total billed charges,18.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.6,20,,,percent of total billed charges,20% of total billed charges,14.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.6,20,,,percent of total billed charges,20% of total billed charges,14.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.45,65,,,percent of total billed charges,65% of total billed charges,47.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.6,49.64,
MICONAZOLE 2% CRM,3500573,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
MICONAZOLE 2% CRM [45 GM,3500574,CDM,250,RC,J3490,HCPCS,outpatient,,,23,11.5,,14.95,65,,,percent of total billed charges,65% of total billed charges,15.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.95,65,,,percent of total billed charges,65% of total billed charges,14.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.6,53.67,
MICONAZOLE 3 [200MG],3500575,CDM,250,RC,J3490,HCPCS,outpatient,,,236.6,118.3,,153.79,65,,,percent of total billed charges,65% of total billed charges,160.89,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.32,20,,,percent of total billed charges,20% of total billed charges,47.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.32,20,,,percent of total billed charges,20% of total billed charges,47.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,153.79,65,,,percent of total billed charges,65% of total billed charges,153.79,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.32,160.89,
MICONAZOLE 7 [100 MG],3500576,CDM,250,RC,J3490,HCPCS,outpatient,,,8.15,4.08,,5.3,65,,,percent of total billed charges,65% of total billed charges,5.54,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.63,20,,,percent of total billed charges,20% of total billed charges,1.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.63,20,,,percent of total billed charges,20% of total billed charges,1.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.3,65,,,percent of total billed charges,65% of total billed charges,5.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.63,53.67,
MICROALBUMIN,3300333,CDM,301,RC,82043,HCPCS,outpatient,,,85,42.5,,55.25,65,,,percent of total billed charges,65% of total billed charges,57.8,68,,,percent of total billed charges,68% of total billed charges,2.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.25,65,,,percent of total billed charges,65% of total billed charges,55.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.43,57.8,
MIDAZOLAM INJ [1 MG/0.2 M,3500577,CDM,636,RC,J2250,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MIDAZOLAM INJ [2 MG/2ML],3500578,CDM,636,RC,J2250,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MIDAZOLAM INJ [5 MG/ML],3500579,CDM,636,RC,J2250,HCPCS,outpatient,,,30.5,15.25,,,,,,other,Not reimbursable per contract ,20.74,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.1,20,,,percent of total billed charges,20% of total billed charges,6.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.1,20,,,percent of total billed charges,20% of total billed charges,6.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.4,80,,,case rate,80% for high cost drug carve out,25.93,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.1,25.93,
MIDODRINE TAB (5MG),3501100,CDM,250,RC,,,outpatient,,,20.8,10.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.16,20,,,percent of total billed charges,20% of total billed charges,4.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.16,20,,,percent of total billed charges,20% of total billed charges,4.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.52,65,,,percent of total billed charges,65% of total billed charges,13.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.16,53.67,
MILK OF MAGNESIA,3500893,CDM,250,RC,J3490,HCPCS,outpatient,,,11.75,5.88,,7.64,65,,,percent of total billed charges,65% of total billed charges,7.99,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.35,20,,,percent of total billed charges,20% of total billed charges,2.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.35,20,,,percent of total billed charges,20% of total billed charges,2.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.64,65,,,percent of total billed charges,65% of total billed charges,7.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.35,53.67,
MINERAL OIL ENEMA,3500581,CDM,250,RC,J3490,HCPCS,outpatient,,,18.1,9.05,,11.77,65,,,percent of total billed charges,65% of total billed charges,12.31,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.62,20,,,percent of total billed charges,20% of total billed charges,3.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.62,20,,,percent of total billed charges,20% of total billed charges,3.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.77,65,,,percent of total billed charges,65% of total billed charges,11.77,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.62,53.67,
MINOR DRAPE FEN 6X6,3250032,CDM,272,RC,,,outpatient,,,36.45,18.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.29,20,,,percent of total billed charges,20% of total billed charges,7.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.29,20,,,percent of total billed charges,20% of total billed charges,7.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.69,65,,,percent of total billed charges,65% of total billed charges,23.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.29,53.67,
MINOXIDIL TAB (2.5MG),3501103,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MIRTAZAPINE TAB [15 MG],3500583,CDM,250,RC,J3490,HCPCS,outpatient,,,14.3,7.15,,9.3,65,,,percent of total billed charges,65% of total billed charges,9.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.86,20,,,percent of total billed charges,20% of total billed charges,2.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.86,20,,,percent of total billed charges,20% of total billed charges,2.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,65,,,percent of total billed charges,65% of total billed charges,9.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.86,53.67,
MOBILITY: WALKING & MOVING AROUND D/C,3600049,CDM,420,RC,G8980,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
MOBILITY: WALKING & MOVING AROUND-GOAL,3600048,CDM,420,RC,G8979,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
MOBILITY: WALKING & MOVING CURRENT,3600047,CDM,420,RC,G8978,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
MOMETASONE FUROATE,3521950,CDM,250,RC,,,outpatient,,,21.6,10.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,20,,,percent of total billed charges,20% of total billed charges,4.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,20,,,percent of total billed charges,20% of total billed charges,4.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,65,,,percent of total billed charges,65% of total billed charges,14.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,53.67,
MONO SPOT TEST,3300487,CDM,302,RC,86308,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,7.34,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.34,27.2,
MONTELUKAST TAB [10 MG],3500584,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MONTELUKAST TAB [4 MG],3500585,CDM,250,RC,J3490,HCPCS,outpatient,,,25.15,12.58,,16.35,65,,,percent of total billed charges,65% of total billed charges,17.1,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.03,20,,,percent of total billed charges,20% of total billed charges,5.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.03,20,,,percent of total billed charges,20% of total billed charges,5.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.35,65,,,percent of total billed charges,65% of total billed charges,16.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.03,53.67,
MORGAN'S LENS,3250035,CDM,272,RC,,,outpatient,,,101.05,50.53,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.21,20,,,percent of total billed charges,20% of total billed charges,20.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.21,20,,,percent of total billed charges,20% of total billed charges,20.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.68,65,,,percent of total billed charges,65% of total billed charges,65.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.21,65.68,
MORPHINE 10 MG/0.5 ML LIQUID,3500593,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
MORPHINE 5MG/ML PF SYR,3501145,CDM,636,RC,J2270,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MORPHINE ER TAB [15 MG],3500586,CDM,250,RC,J3490,HCPCS,outpatient,,,16.3,8.15,,10.6,65,,,percent of total billed charges,65% of total billed charges,11.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.26,20,,,percent of total billed charges,20% of total billed charges,3.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.26,20,,,percent of total billed charges,20% of total billed charges,3.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.6,65,,,percent of total billed charges,65% of total billed charges,10.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.26,53.67,
MORPHINE ER TAB [30 MG],3500587,CDM,250,RC,J3490,HCPCS,outpatient,,,13.1,6.55,,8.52,65,,,percent of total billed charges,65% of total billed charges,8.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.62,20,,,percent of total billed charges,20% of total billed charges,2.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.62,20,,,percent of total billed charges,20% of total billed charges,2.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.52,65,,,percent of total billed charges,65% of total billed charges,8.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,53.67,
MORPHINE ER TAB [60 MG],3500588,CDM,250,RC,J3490,HCPCS,outpatient,,,40.4,20.2,,26.26,65,,,percent of total billed charges,65% of total billed charges,27.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.26,65,,,percent of total billed charges,65% of total billed charges,26.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.08,53.67,
MORPHINE IMR TAB [15 MG],3500589,CDM,250,RC,J3490,HCPCS,outpatient,,,7.95,3.98,,5.17,65,,,percent of total billed charges,65% of total billed charges,5.41,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.59,20,,,percent of total billed charges,20% of total billed charges,1.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.59,20,,,percent of total billed charges,20% of total billed charges,1.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.17,65,,,percent of total billed charges,65% of total billed charges,5.17,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.59,53.67,
MORPHINE INJ [10 MG/ML],3500590,CDM,636,RC,J2270,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MORPHINE INJ [2 MG/ML],3500591,CDM,636,RC,J2270,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MORPHINE INJ [4 MG/ML],3500592,CDM,636,RC,J2270,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
MORPHINE SUSP. (20MG/5ML),3501104,CDM,250,RC,,,outpatient,,,8.3,4.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.66,20,,,percent of total billed charges,20% of total billed charges,1.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.66,20,,,percent of total billed charges,20% of total billed charges,1.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,65,,,percent of total billed charges,65% of total billed charges,5.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.66,53.67,
MRI BRAIN W/O CONTRAST,3400300,CDM,611,RC,70551,HCPCS,outpatient,,,1300,650,,845,65,,,percent of total billed charges,65% of total billed charges,884,68,,,percent of total billed charges,68% of total billed charges,373.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,260,20,,,percent of total billed charges,20% of total billed charges,260,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,260,20,,,percent of total billed charges,20% of total billed charges,260,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,845,65,,,percent of total billed charges,65% of total billed charges,845,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,739,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,780,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,884,
MRI BRAIN W/O CONTRAST,3440100,CDM,972,RC,70551,HCPCS,outpatient,,,325,162.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,166.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.3,110,,,fee schedule,110% of Medicare physician fee schedule,219.3,110,,,fee schedule,110% of Medicare physician fee schedule,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,953.48,115,,,fee schedule,115% of Medicare physician fee schedule,218.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,166.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,252.19,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,166.28,953.48,
MULTIVIT/ FE TAB,3500594,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MULTIVITAMIN INJ,3500595,CDM,258,RC,J3490,HCPCS,outpatient,,,59.55,29.78,,38.71,65,,,percent of total billed charges,65% of total billed charges,40.49,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.91,20,,,percent of total billed charges,20% of total billed charges,11.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.91,20,,,percent of total billed charges,20% of total billed charges,11.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.71,65,,,percent of total billed charges,65% of total billed charges,38.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.91,53.67,
MULTIVITAMIN LIQ [237  ML,3500596,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
MULTIVITAMIN TAB,3500597,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
MUMPS VIRUS IGG,3300537,CDM,302,RC,86735,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,18.52,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,51,
MUPIROCIN OINT 2%  [22 GM,3500599,CDM,250,RC,J3490,HCPCS,outpatient,,,50,25,,32.5,65,,,percent of total billed charges,65% of total billed charges,34,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,53.67,
MYCOPLASMA BLD,3300499,CDM,302,RC,86738,HCPCS,outpatient,,,95,47.5,,61.75,65,,,percent of total billed charges,65% of total billed charges,64.6,68,,,percent of total billed charges,68% of total billed charges,18.8,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.75,65,,,percent of total billed charges,65% of total billed charges,61.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.8,64.6,
MYCOPLASMA PCR SPUTU,3300767,CDM,306,RC,87109,HCPCS,outpatient,,,159,79.5,,103.35,65,,,percent of total billed charges,65% of total billed charges,108.12,68,,,percent of total billed charges,68% of total billed charges,21.83,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.8,20,,,percent of total billed charges,20% of total billed charges,31.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.8,20,,,percent of total billed charges,20% of total billed charges,31.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.35,65,,,percent of total billed charges,65% of total billed charges,103.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.83,108.12,
MYOGLOBIN,3300335,CDM,301,RC,83874,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,18.32,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,57.12,
MYSOLIN(PRIMIDONE),3300113,CDM,301,RC,80188,HCPCS,outpatient,,,85,42.5,,55.25,65,,,percent of total billed charges,65% of total billed charges,57.8,68,,,percent of total billed charges,68% of total billed charges,23.27,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.25,65,,,percent of total billed charges,65% of total billed charges,55.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17,57.8,
N/ DIPH/ PERT INJ ADULT I,3500830,CDM,636,RC,J1670,HCPCS,outpatient,,,236.9,118.45,,,,,,other,Not reimbursable per contract ,161.09,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.38,20,,,percent of total billed charges,20% of total billed charges,47.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.38,20,,,percent of total billed charges,20% of total billed charges,47.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.52,80,,,case rate,80% for high cost drug carve out,201.37,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.38,201.37,
NAFCILLIN SOD INJ [1 GM],3500601,CDM,636,RC,J3490,HCPCS,outpatient,,,65.7,32.85,,,,,,other,Not reimbursable per contract ,44.68,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.14,20,,,percent of total billed charges,20% of total billed charges,13.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.14,20,,,percent of total billed charges,20% of total billed charges,13.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.56,80,,,case rate,80% for high cost drug carve out,55.85,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.14,55.85,
NALOXONE INJ [0.4 MG/ML],3500603,CDM,636,RC,J2310,HCPCS,outpatient,,,80.9,40.45,,,,,,other,Not reimbursable per contract ,55.01,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.18,20,,,percent of total billed charges,20% of total billed charges,16.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.18,20,,,percent of total billed charges,20% of total billed charges,16.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.72,80,,,case rate,80% for high cost drug carve out,68.77,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.18,68.77,
NALOXONE INJ [1 MG/ML],3500604,CDM,636,RC,J2310,HCPCS,outpatient,,,89.1,44.55,,,,,,other,Not reimbursable per contract ,60.59,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.82,20,,,percent of total billed charges,20% of total billed charges,17.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.82,20,,,percent of total billed charges,20% of total billed charges,17.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.28,80,,,case rate,80% for high cost drug carve out,75.74,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.82,75.74,
NAPROXEN TAB [250 MG],3500605,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
NAPROXEN TAB [500 MG],3500606,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
NASAL BONES MIN 3 V,3440155,CDM,972,RC,70160,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.05,110,,,fee schedule,110% of Medicare physician fee schedule,41.05,110,,,fee schedule,110% of Medicare physician fee schedule,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,219.32,115,,,fee schedule,115% of Medicare physician fee schedule,70.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.86,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.21,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.86,219.32,
NASAL BONES MIN 3 VW,3400034,CDM,320,RC,70160,HCPCS,outpatient,,,194,97,,126.1,65,,,percent of total billed charges,65% of total billed charges,131.92,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.8,20,,,percent of total billed charges,20% of total billed charges,38.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.8,20,,,percent of total billed charges,20% of total billed charges,38.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.1,65,,,percent of total billed charges,65% of total billed charges,126.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,116.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
NASAL C02/02 CANNULA,3220261,CDM,272,RC,,,outpatient,,,65,32.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,20,,,percent of total billed charges,20% of total billed charges,13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,20,,,percent of total billed charges,20% of total billed charges,13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.25,65,,,percent of total billed charges,65% of total billed charges,42.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13,53.67,
NASAL CANULA,3220229,CDM,272,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
NASAL HEM ANT/COMPLX,3231111,CDM,450,RC,30903,HCPCS,outpatient,,,275,137.5,,178.75,65,,,percent of total billed charges,65% of total billed charges,187,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55,20,,,percent of total billed charges,20% of total billed charges,55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55,20,,,percent of total billed charges,20% of total billed charges,55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178.75,65,,,percent of total billed charges,65% of total billed charges,178.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,165,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,312,
NASAL HEM/SIMPLE ANT,3231109,CDM,450,RC,30901,HCPCS,outpatient,,,197,98.5,,128.05,65,,,percent of total billed charges,65% of total billed charges,133.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.4,20,,,percent of total billed charges,20% of total billed charges,39.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.4,20,,,percent of total billed charges,20% of total billed charges,39.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,128.05,65,,,percent of total billed charges,65% of total billed charges,128.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.4,178,
NASAL PACK LARGE,3250275,CDM,271,RC,,,outpatient,,,107.75,53.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.55,20,,,percent of total billed charges,20% of total billed charges,21.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.55,20,,,percent of total billed charges,20% of total billed charges,21.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.04,65,,,percent of total billed charges,65% of total billed charges,70.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.55,70.04,
NASO/TRACH SUCTION,3170101,CDM,410,RC,31720,HCPCS,outpatient,,,135.26,67.63,,87.92,65,,,percent of total billed charges,65% of total billed charges,91.98,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.05,20,,,percent of total billed charges,20% of total billed charges,27.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.05,20,,,percent of total billed charges,20% of total billed charges,27.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.92,65,,,percent of total billed charges,65% of total billed charges,87.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.05,312,
NEB/ER/MDI INITIAL,3170077,CDM,410,RC,94640,HCPCS,outpatient,,,217.8,108.9,,141.57,65,,,percent of total billed charges,65% of total billed charges,148.1,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.56,20,,,percent of total billed charges,20% of total billed charges,43.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.56,20,,,percent of total billed charges,20% of total billed charges,43.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.57,65,,,percent of total billed charges,65% of total billed charges,141.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.56,148.1,
NEB/MDI SUB INP/SB/HOSP,3170069,CDM,410,RC,94640,HCPCS,outpatient,,,149.46,74.73,,97.15,65,,,percent of total billed charges,65% of total billed charges,101.63,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.89,20,,,percent of total billed charges,20% of total billed charges,29.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.89,20,,,percent of total billed charges,20% of total billed charges,29.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.15,65,,,percent of total billed charges,65% of total billed charges,97.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.89,101.63,
NEO/ BAC/ POLY OINT,3500607,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
NEO/ BAC/ POLY OINT [EYE],3500608,CDM,250,RC,J3490,HCPCS,outpatient,,,75.1,37.55,,48.82,65,,,percent of total billed charges,65% of total billed charges,51.07,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.02,20,,,percent of total billed charges,20% of total billed charges,15.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.02,20,,,percent of total billed charges,20% of total billed charges,15.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.82,65,,,percent of total billed charges,65% of total billed charges,48.82,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.02,53.67,
NEO/ BAC/ POLY/ DEX OINT,3500609,CDM,250,RC,J3490,HCPCS,outpatient,,,62.9,31.45,,40.89,65,,,percent of total billed charges,65% of total billed charges,42.77,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.58,20,,,percent of total billed charges,20% of total billed charges,12.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.58,20,,,percent of total billed charges,20% of total billed charges,12.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.89,65,,,percent of total billed charges,65% of total billed charges,40.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.58,53.67,
NEO/ BAC/ POLY/ DEX SUSP,3500610,CDM,250,RC,J3490,HCPCS,outpatient,,,19.9,9.95,,12.94,65,,,percent of total billed charges,65% of total billed charges,13.53,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.98,20,,,percent of total billed charges,20% of total billed charges,3.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.98,20,,,percent of total billed charges,20% of total billed charges,3.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.94,65,,,percent of total billed charges,65% of total billed charges,12.94,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,53.67,
NEO/ POLY/ HC DRP SUSP [E,3500611,CDM,250,RC,J3490,HCPCS,outpatient,,,85.7,42.85,,55.71,65,,,percent of total billed charges,65% of total billed charges,58.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.14,20,,,percent of total billed charges,20% of total billed charges,17.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.14,20,,,percent of total billed charges,20% of total billed charges,17.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.71,65,,,percent of total billed charges,65% of total billed charges,55.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.14,58.28,
NEONATAL BILIRUBIN,3300034,CDM,301,RC,82248,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,6.94,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.94,54.4,
NEOSPORIN 0.5 OZ OINT,3511141,CDM,250,RC,,,outpatient,,,10.8,5.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.16,20,,,percent of total billed charges,20% of total billed charges,2.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.16,20,,,percent of total billed charges,20% of total billed charges,2.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.02,65,,,percent of total billed charges,65% of total billed charges,7.02,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.16,53.67,
NEOSTIGMINE 10 MG/ML,3510434,CDM,250,RC,,,outpatient,,,99.15,49.58,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.83,20,,,percent of total billed charges,20% of total billed charges,19.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.83,20,,,percent of total billed charges,20% of total billed charges,19.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.45,65,,,percent of total billed charges,65% of total billed charges,64.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.83,64.45,
NEPHO-VITE TAB,3500612,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
NEUROMUSC RE-ED/15M,3600005,CDM,420,RC,97112,HCPCS,outpatient,,,106,53,,68.9,65,,,percent of total billed charges,65% of total billed charges,72.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.2,20,,,percent of total billed charges,20% of total billed charges,21.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.2,20,,,percent of total billed charges,20% of total billed charges,21.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.9,65,,,percent of total billed charges,65% of total billed charges,68.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.2,82,
NEURONTIN,3300233,CDM,301,RC,80171,HCPCS,outpatient,,,110,55,,71.5,65,,,percent of total billed charges,65% of total billed charges,74.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.5,65,,,percent of total billed charges,65% of total billed charges,71.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22,74.8,
NICARDIPINE HCL 25 MG/10 ML INJECTION,3501122,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
NICOTINE LEVEL,3300349,CDM,301,RC,83887,HCPCS,outpatient,,,101,50.5,,65.65,65,,,percent of total billed charges,65% of total billed charges,68.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.65,65,,,percent of total billed charges,65% of total billed charges,65.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,68.68,
NICOTINE PAT [14 MG/24HR],3500615,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
NICOTINE PAT [21 MG/24HR],3500616,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
NIFEDIPINE ER TAB [30 MG],3500618,CDM,250,RC,J3490,HCPCS,outpatient,,,6.6,3.3,,4.29,65,,,percent of total billed charges,65% of total billed charges,4.49,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.32,20,,,percent of total billed charges,20% of total billed charges,1.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.32,20,,,percent of total billed charges,20% of total billed charges,1.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.29,65,,,percent of total billed charges,65% of total billed charges,4.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.32,53.67,
NIFEDIPINE ER TAB [90 MG],3500619,CDM,250,RC,J3490,HCPCS,outpatient,,,12.85,6.43,,8.35,65,,,percent of total billed charges,65% of total billed charges,8.74,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.57,20,,,percent of total billed charges,20% of total billed charges,2.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.57,20,,,percent of total billed charges,20% of total billed charges,2.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.35,65,,,percent of total billed charges,65% of total billed charges,8.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.57,53.67,
NITROFURANTOIN CAP [100 M,3500620,CDM,250,RC,J3490,HCPCS,outpatient,,,16.9,8.45,,10.99,65,,,percent of total billed charges,65% of total billed charges,11.49,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.38,20,,,percent of total billed charges,20% of total billed charges,3.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.38,20,,,percent of total billed charges,20% of total billed charges,3.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.99,65,,,percent of total billed charges,65% of total billed charges,10.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.38,53.67,
NITROFURANTOIN CAP [50 MG,3500989,CDM,250,RC,J3490,HCPCS,outpatient,,,24.05,12.03,,15.63,65,,,percent of total billed charges,65% of total billed charges,16.35,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.81,20,,,percent of total billed charges,20% of total billed charges,4.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.81,20,,,percent of total billed charges,20% of total billed charges,4.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.63,65,,,percent of total billed charges,65% of total billed charges,15.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.81,53.67,
NITROGLYCERIN 2% OINT [30,3500621,CDM,250,RC,J3490,HCPCS,outpatient,,,7.1,3.55,,4.62,65,,,percent of total billed charges,65% of total billed charges,4.83,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.42,20,,,percent of total billed charges,20% of total billed charges,1.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.42,20,,,percent of total billed charges,20% of total billed charges,1.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.62,65,,,percent of total billed charges,65% of total billed charges,4.62,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.42,53.67,
NITROGLYCERIN 2% OINT [PK,3500622,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
NITROGLYCERIN 50 MG,3511119,CDM,250,RC,,,outpatient,,,16,8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.2,20,,,percent of total billed charges,20% of total billed charges,3.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,65,,,percent of total billed charges,65% of total billed charges,10.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.2,53.67,
NITROGLYCERIN PAT [0.2 MG,3500625,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
NITROGLYCERIN PAT [0.4 MG,3500623,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
NITROGLYCERIN PAT [2.5 MG,3500624,CDM,250,RC,J3490,HCPCS,outpatient,,,14.35,7.18,,9.33,65,,,percent of total billed charges,65% of total billed charges,9.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.87,20,,,percent of total billed charges,20% of total billed charges,2.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.87,20,,,percent of total billed charges,20% of total billed charges,2.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.33,65,,,percent of total billed charges,65% of total billed charges,9.33,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.87,53.67,
NITROGLYCERIN TAB [0.4 MG,3500626,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
NITROGLYCERIN/ D5W PREMIX,3500627,CDM,250,RC,J3490,HCPCS,outpatient,,,104.4,52.2,,67.86,65,,,percent of total billed charges,65% of total billed charges,70.99,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.88,20,,,percent of total billed charges,20% of total billed charges,20.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.88,20,,,percent of total billed charges,20% of total billed charges,20.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.86,65,,,percent of total billed charges,65% of total billed charges,67.86,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.88,70.99,
NITROPRESS INJ [25MG/2ML],3501064,CDM,250,RC,J3490,HCPCS,outpatient,,,432,216,,280.8,65,,,percent of total billed charges,65% of total billed charges,293.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.4,20,,,percent of total billed charges,20% of total billed charges,86.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.4,20,,,percent of total billed charges,20% of total billed charges,86.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,280.8,65,,,percent of total billed charges,65% of total billed charges,280.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,293.76,
NORTRIPTYLINE,3300193,CDM,301,RC,80182,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,129.2,
NOSE HEM/POST W/PKS,3231113,CDM,450,RC,30905,HCPCS,outpatient,,,473,236.5,,307.45,65,,,percent of total billed charges,65% of total billed charges,321.64,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.6,20,,,percent of total billed charges,20% of total billed charges,94.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.6,20,,,percent of total billed charges,20% of total billed charges,94.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,307.45,65,,,percent of total billed charges,65% of total billed charges,307.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,321.64,
NOVOLOG-CHARITY,350801,CDM,636,RC,,,outpatient,,,43.79,21.9,,,,,,other,Not reimbursable per contract ,29.78,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.76,20,,,percent of total billed charges,20% of total billed charges,8.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.76,20,,,percent of total billed charges,20% of total billed charges,8.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.03,80,,,case rate,80% for high cost drug carve out,37.22,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.76,37.22,
NT-PRO BNP,3300456,CDM,301,RC,83880,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40,136,
"NYSTATIN 500,000 U",3510433,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
"NYSTATIN CRM [100,000 UNT",3500629,CDM,250,RC,J3490,HCPCS,outpatient,,,35,17.5,,22.75,65,,,percent of total billed charges,65% of total billed charges,23.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.75,65,,,percent of total billed charges,65% of total billed charges,22.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,53.67,
NYSTATIN CRM 100MU/GM-30GM,3521929,CDM,250,RC,J3490,HCPCS,outpatient,,,52.5,26.25,,34.13,65,,,percent of total billed charges,65% of total billed charges,35.7,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.5,20,,,percent of total billed charges,20% of total billed charges,10.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.5,20,,,percent of total billed charges,20% of total billed charges,10.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.13,65,,,percent of total billed charges,65% of total billed charges,34.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.5,53.67,
NYSTATIN POW [100MU/ GM],3500985,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
"NYSTATIN SUSP [100,000 UN",3500631,CDM,250,RC,J3490,HCPCS,outpatient,,,7.7,3.85,,5.01,65,,,percent of total billed charges,65% of total billed charges,5.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.54,20,,,percent of total billed charges,20% of total billed charges,1.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.54,20,,,percent of total billed charges,20% of total billed charges,1.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.01,65,,,percent of total billed charges,65% of total billed charges,5.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,53.67,
NYSTATIN/ TRIAM CRM [30 G,3500632,CDM,250,RC,J3490,HCPCS,outpatient,,,26.6,13.3,,17.29,65,,,percent of total billed charges,65% of total billed charges,18.09,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.32,20,,,percent of total billed charges,20% of total billed charges,5.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.32,20,,,percent of total billed charges,20% of total billed charges,5.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.29,65,,,percent of total billed charges,65% of total billed charges,17.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.32,53.67,
O2  MASK OR CANNULA,3060111,CDM,272,RC,,,outpatient,,,6.65,3.33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.33,20,,,percent of total billed charges,20% of total billed charges,1.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.33,20,,,percent of total billed charges,20% of total billed charges,1.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,65,,,percent of total billed charges,65% of total billed charges,4.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.33,53.67,
OBSERV/EA ADDITIONAL HR,3040011,CDM,762,RC,G0378,HCPCS,outpatient,,,15.25,7.63,,9.91,65,,,percent of total billed charges,65% of total billed charges,10.37,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.05,20,,,percent of total billed charges,20% of total billed charges,3.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.05,20,,,percent of total billed charges,20% of total billed charges,3.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.91,65,,,percent of total billed charges,65% of total billed charges,9.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,980,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.05,980,
OBSERVATION 1ST HOUR,3040001,CDM,762,RC,G0378,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,980,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40,980,
OBSTETRIC PANEL,3300791,CDM,309,RC,80055,HCPCS,outpatient,,,203.5,101.75,,132.28,65,,,percent of total billed charges,65% of total billed charges,138.38,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.7,20,,,percent of total billed charges,20% of total billed charges,40.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.7,20,,,percent of total billed charges,20% of total billed charges,40.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.28,65,,,percent of total billed charges,65% of total billed charges,132.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.7,138.38,
OBTAINING SCRN PAP SMEAR,3700043,CDM,300,RC,Q0091,HCPCS,outpatient,,,18,9,,11.7,65,,,percent of total billed charges,65% of total billed charges,12.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,20,,,percent of total billed charges,20% of total billed charges,3.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.7,65,,,percent of total billed charges,65% of total billed charges,11.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.6,12.24,
OCCULT BLD OTHER SRC,3300147,CDM,301,RC,82271,HCPCS,outpatient,,,23,11.5,,14.95,65,,,percent of total billed charges,65% of total billed charges,15.64,68,,,percent of total billed charges,68% of total billed charges,4.61,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.95,65,,,percent of total billed charges,65% of total billed charges,14.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.6,15.64,
OCCULT BLD STOOL SCR,3300023,CDM,301,RC,82270,HCPCS,outpatient,,,66,33,,42.9,65,,,percent of total billed charges,65% of total billed charges,44.88,68,,,percent of total billed charges,68% of total billed charges,3.59,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.59,44.88,
OCCULT BLOOD STOOL DX,3300024,CDM,301,RC,82272,HCPCS,outpatient,,,22,11,,14.3,65,,,percent of total billed charges,65% of total billed charges,14.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.4,20,,,percent of total billed charges,20% of total billed charges,4.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.3,65,,,percent of total billed charges,65% of total billed charges,14.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.4,14.96,
OCTREOTIDE ACETATE 0.05 MG/ML,3501137,CDM,636,RC,J2354,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
OFLOXACIN 0.3% DRP [EAR],3500633,CDM,250,RC,,,outpatient,,,95,47.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.75,65,,,percent of total billed charges,65% of total billed charges,61.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19,61.75,
OLANZAPINE TAB [20 MG],3501153,CDM,250,RC,,,outpatient,,,199.15,99.58,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.83,20,,,percent of total billed charges,20% of total billed charges,39.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.83,20,,,percent of total billed charges,20% of total billed charges,39.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.45,65,,,percent of total billed charges,65% of total billed charges,129.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,119.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.83,129.45,
OLANZAPINE TAB [5 MG],3500634,CDM,250,RC,J3490,HCPCS,outpatient,,,66.1,33.05,,42.97,65,,,percent of total billed charges,65% of total billed charges,44.95,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.22,20,,,percent of total billed charges,20% of total billed charges,13.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.22,20,,,percent of total billed charges,20% of total billed charges,13.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.97,65,,,percent of total billed charges,65% of total billed charges,42.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.22,53.67,
OLOPATADINE 0.1% DRP [EYE,3500637,CDM,250,RC,J3490,HCPCS,outpatient,,,348.75,174.38,,226.69,65,,,percent of total billed charges,65% of total billed charges,237.15,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.75,20,,,percent of total billed charges,20% of total billed charges,69.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.75,20,,,percent of total billed charges,20% of total billed charges,69.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,226.69,65,,,percent of total billed charges,65% of total billed charges,226.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,237.15,
OMEGA-3-ACID CAP [1 GM],3500638,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
ONDANSETRON INJ [4MG/2ML],3500641,CDM,636,RC,J2405,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
ONDANSETRON OD TAB [4 MG],3500642,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
OPEN CHOLECYSTECOMY,3462026,CDM,982,RC,47600,HCPCS,outpatient,,,1527,763.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,766.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,1240.03,110,,,fee schedule,110% of Medicare physician fee schedule,1240.03,110,,,fee schedule,110% of Medicare physician fee schedule,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,1296.4,115,,,fee schedule,115% of Medicare physician fee schedule,818.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,766.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,1426.03,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,766.27,1426.03,
OPEN FUSION,6215867,CDM,272,RC,,,outpatient,,,616.25,308.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.25,20,,,percent of total billed charges,20% of total billed charges,123.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.25,20,,,percent of total billed charges,20% of total billed charges,123.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,400.56,65,,,percent of total billed charges,65% of total billed charges,400.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,369.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,400.56,
OPERATING ROOM,3060100,CDM,360,RC,,,outpatient,,,1500,750,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,975,65,,,percent of total billed charges,65% of total billed charges,975,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,525,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,975,
OPERATING ROOM 1ST HOUR,3060258,CDM,360,RC,,,outpatient,,,1635,817.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,327,20,,,percent of total billed charges,20% of total billed charges,327,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,327,20,,,percent of total billed charges,20% of total billed charges,327,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1062.75,65,,,percent of total billed charges,65% of total billed charges,1062.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,572.25,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,981,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1062.75,
OPERATING ROOM ADDL 1/2 HOUR,3060260,CDM,360,RC,,,outpatient,,,816,408,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,163.2,20,,,percent of total billed charges,20% of total billed charges,163.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,163.2,20,,,percent of total billed charges,20% of total billed charges,163.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,530.4,65,,,percent of total billed charges,65% of total billed charges,530.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,285.6,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,489.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,530.4,
OPSITE DRESSING 14X10,3250659,CDM,272,RC,,,outpatient,,,5.72,2.86,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.14,20,,,percent of total billed charges,20% of total billed charges,1.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.14,20,,,percent of total billed charges,20% of total billed charges,1.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.72,65,,,percent of total billed charges,65% of total billed charges,3.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.14,53.67,
OPTICAL ACCESS SYST,6215826,CDM,272,RC,,,outpatient,,,121,60.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.2,20,,,percent of total billed charges,20% of total billed charges,24.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.2,20,,,percent of total billed charges,20% of total billed charges,24.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.65,65,,,percent of total billed charges,65% of total billed charges,78.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.2,78.65,
OPTIFOAM BASIC PAD,3250664,CDM,272,RC,,,outpatient,,,10.98,5.49,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.2,20,,,percent of total billed charges,20% of total billed charges,2.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.2,20,,,percent of total billed charges,20% of total billed charges,2.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.14,65,,,percent of total billed charges,65% of total billed charges,7.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.2,53.67,
OR TOWEL DISP,2000239,CDM,270,RC,,,outpatient,,,34,17,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.1,65,,,percent of total billed charges,65% of total billed charges,22.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.8,53.67,
ORBITS MIN 4 V,3440159,CDM,972,RC,70200,HCPCS,outpatient,,,65,32.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.1,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.46,110,,,fee schedule,110% of Medicare physician fee schedule,51.46,110,,,fee schedule,110% of Medicare physician fee schedule,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,230.2,115,,,fee schedule,115% of Medicare physician fee schedule,75.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,23.1,230.2,
ORBITS MIN 4 VIEW,3400035,CDM,320,RC,70200,HCPCS,outpatient,,,226,113,,146.9,65,,,percent of total billed charges,65% of total billed charges,153.68,68,,,percent of total billed charges,68% of total billed charges,26.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.2,20,,,percent of total billed charges,20% of total billed charges,45.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.2,20,,,percent of total billed charges,20% of total billed charges,45.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.9,65,,,percent of total billed charges,65% of total billed charges,146.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.36,180,
ORGANIC ACIDS,3300317,CDM,301,RC,83918,HCPCS,outpatient,,,108,54,,70.2,65,,,percent of total billed charges,65% of total billed charges,73.44,68,,,percent of total billed charges,68% of total billed charges,20.96,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.6,20,,,percent of total billed charges,20% of total billed charges,21.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.6,20,,,percent of total billed charges,20% of total billed charges,21.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.2,65,,,percent of total billed charges,65% of total billed charges,70.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.96,73.44,
ORPHENADRINE CIT INJ [30,3500644,CDM,636,RC,J2360,HCPCS,outpatient,,,99.95,49.98,,,,,,other,Not reimbursable per contract ,67.97,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.99,20,,,percent of total billed charges,20% of total billed charges,19.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.99,20,,,percent of total billed charges,20% of total billed charges,19.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.96,80,,,case rate,80% for high cost drug carve out,84.96,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.99,84.96,
ORTHOTIC FT TR /15M,3600007,CDM,420,RC,97760,HCPCS,outpatient,,,110,55,,71.5,65,,,percent of total billed charges,65% of total billed charges,74.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.5,65,,,percent of total billed charges,65% of total billed charges,71.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22,82,
OSELTAMIVIR CAP [75 MG],3500645,CDM,250,RC,J3490,HCPCS,outpatient,,,91.15,45.58,,59.25,65,,,percent of total billed charges,65% of total billed charges,61.98,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.23,20,,,percent of total billed charges,20% of total billed charges,18.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.23,20,,,percent of total billed charges,20% of total billed charges,18.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.25,65,,,percent of total billed charges,65% of total billed charges,59.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.23,61.98,
OSELTAMIVIR PHOSPHATE 6MG/ML 1X60ML,3521937,CDM,636,RC,J3490,HCPCS,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,3.4,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,80,,,case rate,80% for high cost drug carve out,4.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,4.25,
OSMOLALITY SERUM,3300203,CDM,301,RC,83930,HCPCS,outpatient,,,59,29.5,,38.35,65,,,percent of total billed charges,65% of total billed charges,40.12,68,,,percent of total billed charges,68% of total billed charges,9.38,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.35,65,,,percent of total billed charges,65% of total billed charges,38.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.38,40.12,
OT EVALUATION HIGH COMPLEXITY,3600092,CDM,430,RC,97167,HCPCS,outpatient,,,304,152,,197.6,65,,,percent of total billed charges,65% of total billed charges,206.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.8,20,,,percent of total billed charges,20% of total billed charges,60.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.8,20,,,percent of total billed charges,20% of total billed charges,60.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,197.6,65,,,percent of total billed charges,65% of total billed charges,197.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,182.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.8,206.72,
OT EVALUATION LOW COMPLEXITY,3600027,CDM,430,RC,97165,HCPCS,outpatient,,,204,102,,132.6,65,,,percent of total billed charges,65% of total billed charges,138.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,65,,,percent of total billed charges,65% of total billed charges,132.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,138.72,
OT EVALUATION MODERATE COMPLEXITY,3600091,CDM,430,RC,97166,HCPCS,outpatient,,,254,127,,165.1,65,,,percent of total billed charges,65% of total billed charges,172.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.8,20,,,percent of total billed charges,20% of total billed charges,50.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.8,20,,,percent of total billed charges,20% of total billed charges,50.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,165.1,65,,,percent of total billed charges,65% of total billed charges,165.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.8,172.72,
OT NEURO RE EDUCA/15MIN,3600029,CDM,430,RC,97112,HCPCS,outpatient,,,101,50.5,,65.65,65,,,percent of total billed charges,65% of total billed charges,68.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.65,65,,,percent of total billed charges,65% of total billed charges,65.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,82,
OT RE-EVALUATION,3600093,CDM,430,RC,97168,HCPCS,outpatient,,,146,73,,94.9,65,,,percent of total billed charges,65% of total billed charges,99.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.2,20,,,percent of total billed charges,20% of total billed charges,29.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.2,20,,,percent of total billed charges,20% of total billed charges,29.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.9,65,,,percent of total billed charges,65% of total billed charges,94.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.2,99.28,
OT SELF MNG TRAIN/ 15 MIN,3600035,CDM,430,RC,97535,HCPCS,outpatient,,,100,50,,65,65,,,percent of total billed charges,65% of total billed charges,68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,65,,,percent of total billed charges,65% of total billed charges,65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20,82,
OT THERAPEUTIC /15MIN,3600031,CDM,430,RC,97110,HCPCS,outpatient,,,63,31.5,,40.95,65,,,percent of total billed charges,65% of total billed charges,42.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,20,,,percent of total billed charges,20% of total billed charges,12.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.95,65,,,percent of total billed charges,65% of total billed charges,40.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,82,
OT THERAPEUTIC ACTIV/15M,3600033,CDM,430,RC,97530,HCPCS,outpatient,,,95,47.5,,61.75,65,,,percent of total billed charges,65% of total billed charges,64.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,20,,,percent of total billed charges,20% of total billed charges,19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.75,65,,,percent of total billed charges,65% of total billed charges,61.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19,82,
OTHER PT/OT CURRENT STATUS,3600059,CDM,420,RC,G8990,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
OTHER PT/OT DISCHARGE STATUS,3600061,CDM,420,RC,G8992,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
OTHER PT/OT GOAL STATUS,3600060,CDM,420,RC,G8991,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
OVA & PARASITES,3300693,CDM,306,RC,87177,HCPCS,outpatient,,,125,62.5,,81.25,65,,,percent of total billed charges,65% of total billed charges,85,68,,,percent of total billed charges,68% of total billed charges,12.63,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,20,,,percent of total billed charges,20% of total billed charges,25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,20,,,percent of total billed charges,20% of total billed charges,25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.25,65,,,percent of total billed charges,65% of total billed charges,81.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,85,
OXALATE 24 HR UA,3300207,CDM,301,RC,83945,HCPCS,outpatient,,,86,43,,55.9,65,,,percent of total billed charges,65% of total billed charges,58.48,68,,,percent of total billed charges,68% of total billed charges,18.28,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.9,65,,,percent of total billed charges,65% of total billed charges,55.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.2,58.48,
OXCARBAZEPINE TAB [150 MG,3500646,CDM,250,RC,J3490,HCPCS,outpatient,,,7.2,3.6,,4.68,65,,,percent of total billed charges,65% of total billed charges,4.9,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,20,,,percent of total billed charges,20% of total billed charges,1.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.44,20,,,percent of total billed charges,20% of total billed charges,1.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.68,65,,,percent of total billed charges,65% of total billed charges,4.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.44,53.67,
OXYBUTYNIN ER TAB [5MG],3501032,CDM,250,RC,J3490,HCPCS,outpatient,,,13.75,6.88,,8.94,65,,,percent of total billed charges,65% of total billed charges,9.35,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.75,20,,,percent of total billed charges,20% of total billed charges,2.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.75,20,,,percent of total billed charges,20% of total billed charges,2.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.94,65,,,percent of total billed charges,65% of total billed charges,8.94,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.75,53.67,
OXYBUTYNIN TAB [5 MG],3500647,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
OXYCARBAMAZEPINE,3300469,CDM,301,RC,80157,HCPCS,outpatient,,,70,35,,45.5,65,,,percent of total billed charges,65% of total billed charges,47.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,65,,,percent of total billed charges,65% of total billed charges,45.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,47.6,
OXYCODONE ER [40 MG],3521926,CDM,250,RC,,,outpatient,,,109.8,54.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.96,20,,,percent of total billed charges,20% of total billed charges,21.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.96,20,,,percent of total billed charges,20% of total billed charges,21.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.37,65,,,percent of total billed charges,65% of total billed charges,71.37,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.96,71.37,
OXYCODONE ER TAB [10 MG],3500648,CDM,250,RC,J3490,HCPCS,outpatient,,,39.5,19.75,,25.68,65,,,percent of total billed charges,65% of total billed charges,26.86,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.9,20,,,percent of total billed charges,20% of total billed charges,7.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.9,20,,,percent of total billed charges,20% of total billed charges,7.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.68,65,,,percent of total billed charges,65% of total billed charges,25.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.9,53.67,
OXYCODONE ER TAB [20 MG],3500649,CDM,250,RC,J3490,HCPCS,outpatient,,,73.55,36.78,,47.81,65,,,percent of total billed charges,65% of total billed charges,50.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.71,20,,,percent of total billed charges,20% of total billed charges,14.71,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.71,20,,,percent of total billed charges,20% of total billed charges,14.71,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.81,65,,,percent of total billed charges,65% of total billed charges,47.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.71,53.67,
OXYCODONE IR TAB [15 MG],3500963,CDM,250,RC,J3490,HCPCS,outpatient,,,16.5,8.25,,10.73,65,,,percent of total billed charges,65% of total billed charges,11.22,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.3,20,,,percent of total billed charges,20% of total billed charges,3.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.3,20,,,percent of total billed charges,20% of total billed charges,3.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.73,65,,,percent of total billed charges,65% of total billed charges,10.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.3,53.67,
OXYCODONE IR TAB [5 MG],3500962,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
OXYCODONE/ ACET TAB [10-3,3500650,CDM,250,RC,J3490,HCPCS,outpatient,,,29.35,14.68,,19.08,65,,,percent of total billed charges,65% of total billed charges,19.96,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.87,20,,,percent of total billed charges,20% of total billed charges,5.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.87,20,,,percent of total billed charges,20% of total billed charges,5.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.08,65,,,percent of total billed charges,65% of total billed charges,19.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.87,53.67,
OXYCODONE/ ACET TAB [5-32,3500651,CDM,250,RC,J3490,HCPCS,outpatient,,,11.95,5.98,,7.77,65,,,percent of total billed charges,65% of total billed charges,8.13,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.39,20,,,percent of total billed charges,20% of total billed charges,2.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.39,20,,,percent of total billed charges,20% of total billed charges,2.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.77,65,,,percent of total billed charges,65% of total billed charges,7.77,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.39,53.67,
OXYGEN USAGE PER HOUR,3170011,CDM,270,RC,,,outpatient,,,52.7,26.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.54,20,,,percent of total billed charges,20% of total billed charges,10.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.54,20,,,percent of total billed charges,20% of total billed charges,10.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.26,65,,,percent of total billed charges,65% of total billed charges,34.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.62,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.54,53.67,
OXYMETAZOLINE HCL NSL SPR,3500982,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
OYSTER SHELL CALC/D TAB [,3501066,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
P BURNS DRESS/DEB MD,3700165,CDM,521,RC,16025,HCPCS,outpatient,,,204,102,,132.6,65,,,percent of total billed charges,65% of total billed charges,138.72,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,65,,,percent of total billed charges,65% of total billed charges,132.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,419,
P BURNS DRESS/DEB SM,3700091,CDM,521,RC,16020,HCPCS,outpatient,,,107,53.5,,69.55,65,,,percent of total billed charges,65% of total billed charges,72.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.55,65,,,percent of total billed charges,65% of total billed charges,69.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.4,178,
P CRYOSRG 1 LESION,3700143,CDM,521,RC,17000,HCPCS,outpatient,,,107,53.5,,69.55,65,,,percent of total billed charges,65% of total billed charges,72.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.55,65,,,percent of total billed charges,65% of total billed charges,69.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.4,178,
P CRYOSURG >1<15 LES,3700141,CDM,521,RC,17003,HCPCS,outpatient,,,129,64.5,,83.85,65,,,percent of total billed charges,65% of total billed charges,87.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.85,65,,,percent of total billed charges,65% of total billed charges,83.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,178,
P CRYOSURG >15 LES,3700167,CDM,521,RC,17004,HCPCS,outpatient,,,204,102,,132.6,65,,,percent of total billed charges,65% of total billed charges,138.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,20,,,percent of total billed charges,20% of total billed charges,40.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.6,65,,,percent of total billed charges,65% of total billed charges,132.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,178,
P DEB INF SKIN 10%,3700151,CDM,521,RC,11000,HCPCS,outpatient,,,388,194,,252.2,65,,,percent of total billed charges,65% of total billed charges,263.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.6,20,,,percent of total billed charges,20% of total billed charges,77.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.6,20,,,percent of total billed charges,20% of total billed charges,77.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,252.2,65,,,percent of total billed charges,65% of total billed charges,252.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,232.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.6,263.84,
P EAR LAVAGE 1-2 EARS,3700169,CDM,521,RC,69210,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,178,
P I&D ABCESS SIMPLE,3700173,CDM,521,RC,10060,HCPCS,outpatient,,,107,53.5,,69.55,65,,,percent of total billed charges,65% of total billed charges,72.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.55,65,,,percent of total billed charges,65% of total billed charges,69.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.4,178,
P WEDGE NAIL EXC,3700201,CDM,521,RC,11765,HCPCS,outpatient,,,107,53.5,,69.55,65,,,percent of total billed charges,65% of total billed charges,72.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.55,65,,,percent of total billed charges,65% of total billed charges,69.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.4,178,
P WR 2.5CM OR < FACE,3700191,CDM,521,RC,12011,HCPCS,outpatient,,,107,53.5,,69.55,65,,,percent of total billed charges,65% of total billed charges,72.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.55,65,,,percent of total billed charges,65% of total billed charges,69.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.4,178,
P-A-P,3300285,CDM,301,RC,84066,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,13.71,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,40.8,
PACKING STRIP 2X5 YD,3250319,CDM,272,RC,,,outpatient,,,69.25,34.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.85,20,,,percent of total billed charges,20% of total billed charges,13.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.85,20,,,percent of total billed charges,20% of total billed charges,13.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.01,65,,,percent of total billed charges,65% of total billed charges,45.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.85,53.67,
"PACKING STRIP IODOFORM 1"" X 5""",3250689,CDM,272,RC,,,outpatient,,,23.5,11.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.7,20,,,percent of total billed charges,20% of total billed charges,4.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.7,20,,,percent of total billed charges,20% of total billed charges,4.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.28,65,,,percent of total billed charges,65% of total billed charges,15.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.7,53.67,
"PACKING STRIP IODOFORM 1/4"" X 15'",3250688,CDM,272,RC,,,outpatient,,,20,10,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,53.67,
PANTOPRAZOLE 20 MG DR TAB,3501051,CDM,250,RC,J3490,HCPCS,outpatient,,,19.95,9.98,,12.97,65,,,percent of total billed charges,65% of total billed charges,13.57,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.99,20,,,percent of total billed charges,20% of total billed charges,3.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.99,20,,,percent of total billed charges,20% of total billed charges,3.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.97,65,,,percent of total billed charges,65% of total billed charges,12.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.99,53.67,
PANTOPRAZOLE SOD TAB [40,3501019,CDM,250,RC,J3490,HCPCS,outpatient,,,20.45,10.23,,13.29,65,,,percent of total billed charges,65% of total billed charges,13.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.09,20,,,percent of total billed charges,20% of total billed charges,4.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.09,20,,,percent of total billed charges,20% of total billed charges,4.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.29,65,,,percent of total billed charges,65% of total billed charges,13.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.09,53.67,
PARACENTESIS,3020017,CDM,360,RC,49082,HCPCS,outpatient,,,437,218.5,,284.05,65,,,percent of total billed charges,65% of total billed charges,297.16,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,284.05,65,,,percent of total billed charges,65% of total billed charges,284.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,665,
PARACENTESIS W/O GUIDANCE,3231120,CDM,450,RC,49082,HCPCS,outpatient,,,437,218.5,,284.05,65,,,percent of total billed charges,65% of total billed charges,297.16,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,284.05,65,,,percent of total billed charges,65% of total billed charges,284.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,665,
PARACENTESIS WITH GUIDANC,3231119,CDM,450,RC,49083,HCPCS,outpatient,,,437,218.5,,284.05,65,,,percent of total billed charges,65% of total billed charges,297.16,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,284.05,65,,,percent of total billed charges,65% of total billed charges,284.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,665,
PARAFFIN BATH,3600019,CDM,420,RC,97018,HCPCS,outpatient,,,62,31,,40.3,65,,,percent of total billed charges,65% of total billed charges,42.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.4,20,,,percent of total billed charges,20% of total billed charges,12.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.3,65,,,percent of total billed charges,65% of total billed charges,40.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.4,82,
PARATHROID HORMONE,3300167,CDM,301,RC,83970,HCPCS,outpatient,,,299,149.5,,194.35,65,,,percent of total billed charges,65% of total billed charges,203.32,68,,,percent of total billed charges,68% of total billed charges,58.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,20,,,percent of total billed charges,20% of total billed charges,59.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,20,,,percent of total billed charges,20% of total billed charges,59.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,194.35,65,,,percent of total billed charges,65% of total billed charges,194.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,149.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.58,203.32,
PARING/CUTTING B9 HYPERKERT LESION >4,3462064,CDM,982,RC,11057,HCPCS,outpatient,,,106,53,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.38,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.65,110,,,fee schedule,110% of Medicare physician fee schedule,31.65,110,,,fee schedule,110% of Medicare physician fee schedule,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,33.09,115,,,fee schedule,115% of Medicare physician fee schedule,71.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.39,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.38,71.98,
PARING/CUTTING BENIGN LESION 1,3462053,CDM,982,RC,11055,HCPCS,outpatient,,,90,45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,10.85,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.01,110,,,fee schedule,110% of Medicare physician fee schedule,18.01,110,,,fee schedule,110% of Medicare physician fee schedule,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.83,115,,,fee schedule,115% of Medicare physician fee schedule,63.45,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,10.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,10.85,63.45,
PARING/CUTTING BENIGN LESION 2-4,3462054,CDM,982,RC,11056,HCPCS,outpatient,,,105,52.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.65,110,,,fee schedule,110% of Medicare physician fee schedule,24.65,110,,,fee schedule,110% of Medicare physician fee schedule,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.77,115,,,fee schedule,115% of Medicare physician fee schedule,67.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,15,100,,,fee schedule,100% of FL Medicaid fee schedule ,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,28.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15,67.6,
PAROXETINE TAB [10 MG],3500654,CDM,250,RC,J3490,HCPCS,outpatient,,,13.1,6.55,,8.52,65,,,percent of total billed charges,65% of total billed charges,8.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.62,20,,,percent of total billed charges,20% of total billed charges,2.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.62,20,,,percent of total billed charges,20% of total billed charges,2.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.52,65,,,percent of total billed charges,65% of total billed charges,8.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.62,53.67,
PAROXETINE TAB [20 MG],3500655,CDM,250,RC,J3490,HCPCS,outpatient,,,13.65,6.83,,8.87,65,,,percent of total billed charges,65% of total billed charges,9.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.73,20,,,percent of total billed charges,20% of total billed charges,2.73,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.73,20,,,percent of total billed charges,20% of total billed charges,2.73,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.87,65,,,percent of total billed charges,65% of total billed charges,8.87,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.19,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.73,53.67,
PART/THROMBOPLASTIN,3300637,CDM,305,RC,85730,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,8.52,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.52,40.8,
PARVOVIRUS B19 HUMAN IGG,3300454,CDM,301,RC,86747,HCPCS,outpatient,,,127.5,63.75,,82.88,65,,,percent of total billed charges,65% of total billed charges,86.7,68,,,percent of total billed charges,68% of total billed charges,21.33,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.5,20,,,percent of total billed charges,20% of total billed charges,25.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.5,20,,,percent of total billed charges,20% of total billed charges,25.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.88,65,,,percent of total billed charges,65% of total billed charges,82.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.33,86.7,
PEAK FLOW METER,3170051,CDM,272,RC,,,outpatient,,,149,74.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.8,20,,,percent of total billed charges,20% of total billed charges,29.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.8,20,,,percent of total billed charges,20% of total billed charges,29.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96.85,65,,,percent of total billed charges,65% of total billed charges,96.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,89.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.8,96.85,
PEDS ELECTRODES ONE STEP,3250653,CDM,272,RC,,,outpatient,,,251.6,125.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.32,20,,,percent of total billed charges,20% of total billed charges,50.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.32,20,,,percent of total billed charges,20% of total billed charges,50.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,163.54,65,,,percent of total billed charges,65% of total billed charges,163.54,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.32,163.54,
PEG 24 PULL,6215811,CDM,272,RC,,,outpatient,,,377,188.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.4,20,,,percent of total billed charges,20% of total billed charges,75.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.4,20,,,percent of total billed charges,20% of total billed charges,75.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,245.05,65,,,percent of total billed charges,65% of total billed charges,245.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,226.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,245.05,
PEG KITS,3060177,CDM,272,RC,,,outpatient,,,461,230.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.2,20,,,percent of total billed charges,20% of total billed charges,92.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.2,20,,,percent of total billed charges,20% of total billed charges,92.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,299.65,65,,,percent of total billed charges,65% of total billed charges,299.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,276.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,299.65,
PELVIS 1-2 V,3440161,CDM,972,RC,72170,HCPCS,outpatient,,,48.4,24.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.46,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.18,110,,,fee schedule,110% of Medicare physician fee schedule,30.18,110,,,fee schedule,110% of Medicare physician fee schedule,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,207.96,115,,,fee schedule,115% of Medicare physician fee schedule,70.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.46,207.96,
PELVIS 1-2 VIEW,3400036,CDM,320,RC,72170,HCPCS,outpatient,,,212,106,,137.8,65,,,percent of total billed charges,65% of total billed charges,144.16,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.8,65,,,percent of total billed charges,65% of total billed charges,137.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
PENICILLIN TAB (500MG),3501102,CDM,250,RC,,,outpatient,,,5.85,2.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.17,20,,,percent of total billed charges,20% of total billed charges,1.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.17,20,,,percent of total billed charges,20% of total billed charges,1.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.8,65,,,percent of total billed charges,65% of total billed charges,3.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.17,53.67,
PENICILLIN VK SUSP [250 M,3500657,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PENICILLIN VK TAB [250 MG,3500658,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PERI/CLEANS BTL 8OZ,3250189,CDM,271,RC,,,outpatient,,,3.5,1.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.7,20,,,percent of total billed charges,20% of total billed charges,0.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.7,20,,,percent of total billed charges,20% of total billed charges,0.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.28,65,,,percent of total billed charges,65% of total billed charges,2.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.7,53.67,
PERIPHERAL NERV BLK,3231123,CDM,450,RC,64450,HCPCS,outpatient,,,259,129.5,,168.35,65,,,percent of total billed charges,65% of total billed charges,176.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.8,20,,,percent of total billed charges,20% of total billed charges,51.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.8,20,,,percent of total billed charges,20% of total billed charges,51.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168.35,65,,,percent of total billed charges,65% of total billed charges,168.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,155.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.8,296,
PERIPHERAL SMEAR,3300921,CDM,301,RC,85060,HCPCS,outpatient,,,30,15,,19.5,65,,,percent of total billed charges,65% of total billed charges,20.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,20.4,
PERMETHRIN 5% CRM,3500660,CDM,250,RC,J3490,HCPCS,outpatient,,,43.1,21.55,,28.02,65,,,percent of total billed charges,65% of total billed charges,29.31,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.62,20,,,percent of total billed charges,20% of total billed charges,8.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.62,20,,,percent of total billed charges,20% of total billed charges,8.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.02,65,,,percent of total billed charges,65% of total billed charges,28.02,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.62,53.67,
PERMETHRIN CRM,3500004,CDM,250,RC,,,outpatient,,,237.6,118.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.52,20,,,percent of total billed charges,20% of total billed charges,47.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.52,20,,,percent of total billed charges,20% of total billed charges,47.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,154.44,65,,,percent of total billed charges,65% of total billed charges,154.44,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.52,154.44,
PFT SIMPLE PRE,3170091,CDM,460,RC,94010,HCPCS,outpatient,,,325,162.5,,211.25,65,,,percent of total billed charges,65% of total billed charges,221,68,,,percent of total billed charges,68% of total billed charges,14.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,20,,,percent of total billed charges,20% of total billed charges,65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,20,,,percent of total billed charges,20% of total billed charges,65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,211.25,65,,,percent of total billed charges,65% of total billed charges,211.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,221,
PFT TOTAL,3170095,CDM,460,RC,94060,HCPCS,outpatient,,,425,212.5,,276.25,65,,,percent of total billed charges,65% of total billed charges,289,68,,,percent of total billed charges,68% of total billed charges,31.31,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,20,,,percent of total billed charges,20% of total billed charges,85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,20,,,percent of total billed charges,20% of total billed charges,85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,276.25,65,,,percent of total billed charges,65% of total billed charges,276.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,255,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.31,289,
PH BODY FLUID,3300925,CDM,301,RC,83986,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,5.08,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.08,40.8,
PHENAZOPYRIDINE TAB [200,3500662,CDM,250,RC,J3490,HCPCS,outpatient,,,20,10,,13,65,,,percent of total billed charges,65% of total billed charges,13.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,53.67,
PHENOBARBITAL,3300131,CDM,301,RC,80184,HCPCS,outpatient,,,55,27.5,,35.75,65,,,percent of total billed charges,65% of total billed charges,37.4,68,,,percent of total billed charges,68% of total billed charges,16.26,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.75,65,,,percent of total billed charges,65% of total billed charges,35.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11,37.4,
PHENOBARBITAL TAB [32.4 M,3500664,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
PHENOL LOZ,3500665,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PHENYLALANINE,3300421,CDM,301,RC,84030,HCPCS,outpatient,,,124.25,62.13,,80.76,65,,,percent of total billed charges,65% of total billed charges,84.49,68,,,percent of total billed charges,68% of total billed charges,7.81,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.85,20,,,percent of total billed charges,20% of total billed charges,24.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.85,20,,,percent of total billed charges,20% of total billed charges,24.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.76,65,,,percent of total billed charges,65% of total billed charges,80.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.13,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,74.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.81,84.49,
PHENYLEPHRINE 100 MG/ML,3501264,CDM,636,RC,J2370,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
PHENYLEPHRINE HCL INJ [10,3500666,CDM,636,RC,J2370,HCPCS,outpatient,,,32.4,16.2,,,,,,other,Not reimbursable per contract ,22.03,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.48,20,,,percent of total billed charges,20% of total billed charges,6.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.48,20,,,percent of total billed charges,20% of total billed charges,6.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.92,80,,,case rate,80% for high cost drug carve out,27.54,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.48,27.54,
PHENYTOIN CAP [100 MG],3500667,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PHENYTOIN LEVEL,3300099,CDM,301,RC,80185,HCPCS,outpatient,,,70,35,,45.5,65,,,percent of total billed charges,65% of total billed charges,47.6,68,,,percent of total billed charges,68% of total billed charges,18.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,65,,,percent of total billed charges,65% of total billed charges,45.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,47.6,
PHENYTOIN ORAL SUSPENSION 125MG/5ML,3501127,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PHENYTOIN SOD INJ [100 MG,3500668,CDM,636,RC,J1165,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
PHENYTOIN SOD INJ [250 MG,3500669,CDM,636,RC,J1165,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
PHENYTOIN SUSP [100 MG/4,3500670,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PHLEBOTOMY THERAPEUT,3300851,CDM,940,RC,99195,HCPCS,outpatient,,,83,41.5,,53.95,65,,,percent of total billed charges,65% of total billed charges,56.44,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.95,65,,,percent of total billed charges,65% of total billed charges,53.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.6,74,
PHNYL/ MO/ SHLVO/ PET OIN,3500671,CDM,250,RC,J3490,HCPCS,outpatient,,,14,7,,9.1,65,,,percent of total billed charges,65% of total billed charges,9.52,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.1,65,,,percent of total billed charges,65% of total billed charges,9.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,53.67,
PHOSPHORUS,3300061,CDM,301,RC,84100,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,6.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
PHYSICAL EST 1-4 YR,3700113,CDM,521,RC,99392,HCPCS,outpatient,,,56,28,,36.4,65,,,percent of total billed charges,65% of total billed charges,38.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.2,20,,,percent of total billed charges,20% of total billed charges,11.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.2,20,,,percent of total billed charges,20% of total billed charges,11.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.4,65,,,percent of total billed charges,65% of total billed charges,36.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,38.08,
PHYSICAL EST 12-17 YR,3700117,CDM,521,RC,99394,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,46.24,
PHYSICAL EST 18-39 YR,3700119,CDM,521,RC,99395,HCPCS,outpatient,,,86,43,,55.9,65,,,percent of total billed charges,65% of total billed charges,58.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.9,65,,,percent of total billed charges,65% of total billed charges,55.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.2,58.48,
PHYSICAL EST 40-64 YR,3700121,CDM,521,RC,99396,HCPCS,outpatient,,,86,43,,55.9,65,,,percent of total billed charges,65% of total billed charges,58.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.9,65,,,percent of total billed charges,65% of total billed charges,55.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.2,58.48,
PHYSICAL EST 5-11 YR,3700115,CDM,521,RC,99393,HCPCS,outpatient,,,56,28,,36.4,65,,,percent of total billed charges,65% of total billed charges,38.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.2,20,,,percent of total billed charges,20% of total billed charges,11.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.2,20,,,percent of total billed charges,20% of total billed charges,11.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.4,65,,,percent of total billed charges,65% of total billed charges,36.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,38.08,
PHYSICAL EST 65-+ YR,3700123,CDM,521,RC,99397,HCPCS,outpatient,,,86,43,,55.9,65,,,percent of total billed charges,65% of total billed charges,58.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.2,20,,,percent of total billed charges,20% of total billed charges,17.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.9,65,,,percent of total billed charges,65% of total billed charges,55.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.2,58.48,
PHYSICAL NEW  40-64 YR,3700107,CDM,521,RC,99386,HCPCS,outpatient,,,129,64.5,,83.85,65,,,percent of total billed charges,65% of total billed charges,87.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.85,65,,,percent of total billed charges,65% of total billed charges,83.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,87.72,
PHYSICAL NEW 0-1YR,3700101,CDM,521,RC,99381,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,46.24,
PHYSICAL NEW 1-4 YR,3700103,CDM,521,RC,99382,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,46.24,
PHYSICAL NEW 12-17 YR,3700133,CDM,521,RC,99384,HCPCS,outpatient,,,91,45.5,,59.15,65,,,percent of total billed charges,65% of total billed charges,61.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.2,20,,,percent of total billed charges,20% of total billed charges,18.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.2,20,,,percent of total billed charges,20% of total billed charges,18.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.15,65,,,percent of total billed charges,65% of total billed charges,59.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.2,61.88,
PHYSICAL NEW 18-39 YR,3700097,CDM,521,RC,99385,HCPCS,outpatient,,,129,64.5,,83.85,65,,,percent of total billed charges,65% of total billed charges,87.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.85,65,,,percent of total billed charges,65% of total billed charges,83.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,87.72,
PHYSICAL NEW 5-11 YR,3700105,CDM,521,RC,99383,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,46.24,
PHYSICAL NEW 65-+ YR,3700109,CDM,521,RC,99387,HCPCS,outpatient,,,129,64.5,,83.85,65,,,percent of total billed charges,65% of total billed charges,87.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,20,,,percent of total billed charges,20% of total billed charges,25.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.85,65,,,percent of total billed charges,65% of total billed charges,83.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,87.72,
PHYSICAL PRE-EMPLOY,3700147,CDM,521,RC,99395,HCPCS,outpatient,,,90.4,45.2,,58.76,65,,,percent of total billed charges,65% of total billed charges,61.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.08,20,,,percent of total billed charges,20% of total billed charges,18.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.08,20,,,percent of total billed charges,20% of total billed charges,18.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.76,65,,,percent of total billed charges,65% of total billed charges,58.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.2,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.08,61.47,
PHYSICAL REEVAL 0-1 YR,3700111,CDM,521,RC,99391,HCPCS,outpatient,,,56,28,,36.4,65,,,percent of total billed charges,65% of total billed charges,38.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.2,20,,,percent of total billed charges,20% of total billed charges,11.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.2,20,,,percent of total billed charges,20% of total billed charges,11.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.4,65,,,percent of total billed charges,65% of total billed charges,36.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,38.08,
PHYSICAL SCHOOL,3700193,CDM,521,RC,99393,HCPCS,outpatient,,,34,17,,22.1,65,,,percent of total billed charges,65% of total billed charges,23.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.1,65,,,percent of total billed charges,65% of total billed charges,22.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.8,23.12,
PHYSICAL SPORTS,3700095,CDM,521,RC,99384,HCPCS,outpatient,,,103.38,51.69,,67.2,65,,,percent of total billed charges,65% of total billed charges,70.3,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.68,20,,,percent of total billed charges,20% of total billed charges,20.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.68,20,,,percent of total billed charges,20% of total billed charges,20.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,65,,,percent of total billed charges,65% of total billed charges,67.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.69,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.68,70.3,
PHYTONADIONE INJ [1 MG/0.,3500672,CDM,636,RC,J3430,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
PICC DRES CHANGE KIT,3250630,CDM,272,RC,,,outpatient,,,103.85,51.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.77,20,,,percent of total billed charges,20% of total billed charges,20.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.77,20,,,percent of total billed charges,20% of total billed charges,20.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.5,65,,,percent of total billed charges,65% of total billed charges,67.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.77,67.5,
PICC INSERTION KIT - 5FR,3250626,CDM,272,RC,,,outpatient,,,173.1,86.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.62,20,,,percent of total billed charges,20% of total billed charges,34.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.62,20,,,percent of total billed charges,20% of total billed charges,34.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.52,65,,,percent of total billed charges,65% of total billed charges,112.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.86,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.62,112.52,
PICC INSERTION KIT 4 FR,3250629,CDM,272,RC,,,outpatient,,,947,473.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.4,20,,,percent of total billed charges,20% of total billed charges,189.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.4,20,,,percent of total billed charges,20% of total billed charges,189.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,615.55,65,,,percent of total billed charges,65% of total billed charges,615.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,568.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,615.55,
PIGTAIL PNEUMO 10.2FR,3521985,CDM,272,RC,,,outpatient,,,384.15,192.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.83,20,,,percent of total billed charges,20% of total billed charges,76.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.83,20,,,percent of total billed charges,20% of total billed charges,76.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,249.7,65,,,percent of total billed charges,65% of total billed charges,249.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,249.7,
PIGTAIL PNEUMO CATH,3521981,CDM,272,RC,,,outpatient,,,263.3,131.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.66,20,,,percent of total billed charges,20% of total billed charges,52.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.66,20,,,percent of total billed charges,20% of total billed charges,52.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,171.15,65,,,percent of total billed charges,65% of total billed charges,171.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.66,171.15,
PIN WORM PREP,3300695,CDM,306,RC,87172,HCPCS,outpatient,,,50,25,,32.5,65,,,percent of total billed charges,65% of total billed charges,34,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,34,
PINCH GRAFT 1/MLT SM ULCER TIP/OTH 2CM,3462057,CDM,982,RC,15050,HCPCS,outpatient,,,785,392.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,313.35,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,515.36,110,,,fee schedule,110% of Medicare physician fee schedule,515.36,110,,,fee schedule,110% of Medicare physician fee schedule,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,538.79,115,,,fee schedule,115% of Medicare physician fee schedule,365.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,313.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,592.67,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,313.35,592.67,
PIOGLITAZONE TAB [15 MG],3500674,CDM,250,RC,J3490,HCPCS,outpatient,,,35.05,17.53,,22.78,65,,,percent of total billed charges,65% of total billed charges,23.83,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.01,20,,,percent of total billed charges,20% of total billed charges,7.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.01,20,,,percent of total billed charges,20% of total billed charges,7.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.78,65,,,percent of total billed charges,65% of total billed charges,22.78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.01,53.67,
PIPERACILLIN/ TAZO INJ [2,3500677,CDM,636,RC,J2543,HCPCS,outpatient,,,37.1,18.55,,,,,,other,Not reimbursable per contract ,25.23,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.42,20,,,percent of total billed charges,20% of total billed charges,7.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.42,20,,,percent of total billed charges,20% of total billed charges,7.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.68,80,,,case rate,80% for high cost drug carve out,31.54,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.42,31.54,
PIPERACILLIN/ TAZO INJ [3,3500678,CDM,636,RC,J2543,HCPCS,outpatient,,,97.9,48.95,,,,,,other,Not reimbursable per contract ,66.57,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.58,20,,,percent of total billed charges,20% of total billed charges,19.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.58,20,,,percent of total billed charges,20% of total billed charges,19.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.32,80,,,case rate,80% for high cost drug carve out,83.22,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.58,83.22,
PIPERACILLIN/TAZ 4.5G INJ,3501139,CDM,636,RC,J2543,HCPCS,outpatient,,,83,41.5,,,,,,other,Not reimbursable per contract ,56.44,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.4,80,,,case rate,80% for high cost drug carve out,70.55,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.6,70.55,
PITOCIN 10 UNITS /ML INJ,3501121,CDM,636,RC,J2590,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
PLACEMENT SETON,3462040,CDM,982,RC,46020,HCPCS,outpatient,,,382,191,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,148.41,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.41,110,,,fee schedule,110% of Medicare physician fee schedule,132.41,110,,,fee schedule,110% of Medicare physician fee schedule,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.43,115,,,fee schedule,115% of Medicare physician fee schedule,201.01,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.41,100,,,fee schedule,100% of FL Medicaid fee schedule ,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,152.27,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,132.41,201.01,
PLACEMENT/PICC LINE,3020033,CDM,360,RC,36569,HCPCS,outpatient,,,280,140,,182,65,,,percent of total billed charges,65% of total billed charges,190.4,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,65,,,percent of total billed charges,65% of total billed charges,182,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,312,
PLASMA LYTE DEX 5 1M,3521879,CDM,258,RC,,,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.2,20,,,percent of total billed charges,20% of total billed charges,13.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,65,,,percent of total billed charges,65% of total billed charges,42.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.2,53.67,
PLATELET AUTOMATED,3300685,CDM,305,RC,85049,HCPCS,outpatient,,,20,10,,13,65,,,percent of total billed charges,65% of total billed charges,13.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4,13.6,
PLATELET COUNT,3300667,CDM,305,RC,85032,HCPCS,outpatient,,,340,170,,221,65,,,percent of total billed charges,65% of total billed charges,231.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68,20,,,percent of total billed charges,20% of total billed charges,68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68,20,,,percent of total billed charges,20% of total billed charges,68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,221,65,,,percent of total billed charges,65% of total billed charges,221,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68,231.2,
PLATELET PHER PROC/STORAG,3300010,CDM,390,RC,P9034,HCPCS,outpatient,,,384.74,192.37,,250.08,65,,,percent of total billed charges,65% of total billed charges,261.62,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.95,20,,,percent of total billed charges,20% of total billed charges,76.95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.95,20,,,percent of total billed charges,20% of total billed charges,76.95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.08,65,,,percent of total billed charges,65% of total billed charges,250.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,261.62,
PLATELET PROC/STORAGE,3300000,CDM,390,RC,P9019,HCPCS,outpatient,,,175,87.5,,113.75,65,,,percent of total billed charges,65% of total billed charges,119,68,,,percent of total billed charges,68% of total billed charges,44,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,20,,,percent of total billed charges,20% of total billed charges,35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,113.75,65,,,percent of total billed charges,65% of total billed charges,113.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35,119,
PLATELET-PHERESIS,3300847,CDM,384,RC,P9034,HCPCS,outpatient,,,510,255,,331.5,65,,,percent of total billed charges,65% of total billed charges,346.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102,20,,,percent of total billed charges,20% of total billed charges,102,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102,20,,,percent of total billed charges,20% of total billed charges,102,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,331.5,65,,,percent of total billed charges,65% of total billed charges,331.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,306,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,346.8,
PLATELETS-EACH UNIT,3300845,CDM,384,RC,P9019,HCPCS,outpatient,,,59,29.5,,38.35,65,,,percent of total billed charges,65% of total billed charges,40.12,68,,,percent of total billed charges,68% of total billed charges,44,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.35,65,,,percent of total billed charges,65% of total billed charges,38.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.8,53.67,
"PLUG & PATCH, LARGE",6215889,CDM,278,RC,,,both,,,436.9,218.45,,,,,,other,Not reimbursable per contract ,297.09,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.38,20,,,percent of total billed charges,20% of total billed charges,87.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.38,20,,,percent of total billed charges,20% of total billed charges,87.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,349.52,80,,,case rate,80% for implant carve out,371.37,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,371.37,
"PLUG & PATCH, MED",6215892,CDM,278,RC,,,both,,,431.5,215.75,,,,,,other,Not reimbursable per contract ,293.42,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.3,20,,,percent of total billed charges,20% of total billed charges,86.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.3,20,,,percent of total billed charges,20% of total billed charges,86.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,345.2,80,,,case rate,80% for implant carve out,366.78,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,258.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,366.78,
"PLUG & PATCH, SMALL",6215891,CDM,278,RC,,,both,,,429,214.5,,,,,,other,Not reimbursable per contract ,291.72,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.8,20,,,percent of total billed charges,20% of total billed charges,85.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.8,20,,,percent of total billed charges,20% of total billed charges,85.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,343.2,80,,,case rate,80% for implant carve out,364.65,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,257.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,364.65,
"PLUG & PATCH, XL",6215890,CDM,278,RC,,,both,,,503.8,251.9,,,,,,other,Not reimbursable per contract ,342.59,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.76,20,,,percent of total billed charges,20% of total billed charges,100.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.76,20,,,percent of total billed charges,20% of total billed charges,100.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,403.04,80,,,case rate,80% for implant carve out,428.23,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,428.23,
PNEUMOCL ADMIN-OBSERV,3040027,CDM,771,RC,G0009,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,85,
"Pneumocystis jirovecii (P. carinii), DFA",3300937,CDM,300,RC,87281,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,57.12,
POLY TRAP,3060191,CDM,272,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
POLYCARBOPHIL TAB [625 MG,3500679,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
POLYETH GLYCL 3350 [17 GM,3500582,CDM,250,RC,,,outpatient,,,9.45,4.73,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,20,,,percent of total billed charges,20% of total billed charges,1.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,20,,,percent of total billed charges,20% of total billed charges,1.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.14,65,,,percent of total billed charges,65% of total billed charges,6.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.89,53.67,
POLYMYXIN/ TMP DRP [EYE],3500682,CDM,250,RC,J3490,HCPCS,outpatient,,,6.75,3.38,,4.39,65,,,percent of total billed charges,65% of total billed charges,4.59,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.35,20,,,percent of total billed charges,20% of total billed charges,1.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.35,20,,,percent of total billed charges,20% of total billed charges,1.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.39,65,,,percent of total billed charges,65% of total billed charges,4.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.35,53.67,
POLYPECTOMY SNARE,3060147,CDM,272,RC,,,outpatient,,,132,66,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.4,20,,,percent of total billed charges,20% of total billed charges,26.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.4,20,,,percent of total billed charges,20% of total billed charges,26.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.8,65,,,percent of total billed charges,65% of total billed charges,85.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.4,85.8,
POOLING OF PH/OTHER,3300803,CDM,309,RC,86965,HCPCS,outpatient,,,93,46.5,,60.45,65,,,percent of total billed charges,65% of total billed charges,63.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,20,,,percent of total billed charges,20% of total billed charges,18.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.45,65,,,percent of total billed charges,65% of total billed charges,60.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,63.24,
PORTACATH AGE 5/>,3462008,CDM,982,RC,36561,HCPCS,outpatient,,,470,235,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,226.37,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,374.58,110,,,fee schedule,110% of Medicare physician fee schedule,374.58,110,,,fee schedule,110% of Medicare physician fee schedule,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,391.61,115,,,fee schedule,115% of Medicare physician fee schedule,278.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.37,100,,,fee schedule,100% of FL Medicaid fee schedule ,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,430.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,226.37,430.77,
POSEY HEEL PROTECTOR,3521980,CDM,270,RC,,,outpatient,,,269,134.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.8,20,,,percent of total billed charges,20% of total billed charges,53.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.8,20,,,percent of total billed charges,20% of total billed charges,53.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.85,65,,,percent of total billed charges,65% of total billed charges,174.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,161.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,174.85,
"POSITIONER, FOAM HEAD",6215772,CDM,270,RC,,,outpatient,,,65.3,32.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.06,20,,,percent of total billed charges,20% of total billed charges,13.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.06,20,,,percent of total billed charges,20% of total billed charges,13.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.45,65,,,percent of total billed charges,65% of total billed charges,42.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.06,53.67,
POTASSIUM,3300063,CDM,301,RC,84132,HCPCS,outpatient,,,23,11.5,,14.95,65,,,percent of total billed charges,65% of total billed charges,15.64,68,,,percent of total billed charges,68% of total billed charges,6.52,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.95,65,,,percent of total billed charges,65% of total billed charges,14.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.6,15.64,
POTASSIUM 20 MEQ .45NS,3521909,CDM,258,RC,,,outpatient,,,15.8,7.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.16,20,,,percent of total billed charges,20% of total billed charges,3.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.16,20,,,percent of total billed charges,20% of total billed charges,3.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.27,65,,,percent of total billed charges,65% of total billed charges,10.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.16,53.67,
POTASSIUM 20MEQ 0.9NS,3521911,CDM,258,RC,,,outpatient,,,23.6,11.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.72,20,,,percent of total billed charges,20% of total billed charges,4.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.72,20,,,percent of total billed charges,20% of total billed charges,4.72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.34,65,,,percent of total billed charges,65% of total billed charges,15.34,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.72,53.67,
POTASSIUM BICARB TAB [25,3500683,CDM,250,RC,J3490,HCPCS,outpatient,,,6.3,3.15,,4.1,65,,,percent of total billed charges,65% of total billed charges,4.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.26,20,,,percent of total billed charges,20% of total billed charges,1.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.26,20,,,percent of total billed charges,20% of total billed charges,1.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.1,65,,,percent of total billed charges,65% of total billed charges,4.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.26,53.67,
POTASSIUM CHLORIDE 20 MEQ/100 ML,3501132,CDM,636,RC,J3480,HCPCS,outpatient,,,54,27,,,,,,other,Not reimbursable per contract ,36.72,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.8,20,,,percent of total billed charges,20% of total billed charges,10.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,80,,,case rate,80% for high cost drug carve out,45.9,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.8,45.9,
POTASSIUM CL LIQ [20 MEQ/,3500684,CDM,250,RC,J3490,HCPCS,outpatient,,,76.1,38.05,,49.47,65,,,percent of total billed charges,65% of total billed charges,51.75,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.22,20,,,percent of total billed charges,20% of total billed charges,15.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.22,20,,,percent of total billed charges,20% of total billed charges,15.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.47,65,,,percent of total billed charges,65% of total billed charges,49.47,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.22,53.67,
POTASSIUM CL TAB [10 MEQ],3500686,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
POTASSIUM CL TAB [20 MEQ],3500687,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
POUCH AIO,3250695,CDM,272,RC,,,outpatient,,,19.25,9.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.85,20,,,percent of total billed charges,20% of total billed charges,3.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.85,20,,,percent of total billed charges,20% of total billed charges,3.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.51,65,,,percent of total billed charges,65% of total billed charges,12.51,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.55,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.85,53.67,
"POUCH, UROSTOMY 1 3/4",3250686,CDM,272,RC,,,outpatient,,,16.2,8.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.24,20,,,percent of total billed charges,20% of total billed charges,3.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.24,20,,,percent of total billed charges,20% of total billed charges,3.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.53,65,,,percent of total billed charges,65% of total billed charges,10.53,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,53.67,
PRAMIPEXOLE DI-HCL TAB [1,3501052,CDM,250,RC,J3490,HCPCS,outpatient,,,29.1,14.55,,18.92,65,,,percent of total billed charges,65% of total billed charges,19.79,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.82,20,,,percent of total billed charges,20% of total billed charges,5.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.82,20,,,percent of total billed charges,20% of total billed charges,5.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.92,65,,,percent of total billed charges,65% of total billed charges,18.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.82,53.67,
PRAMIPEXOLE TAB [0.25 MG],3500688,CDM,250,RC,J3490,HCPCS,outpatient,,,14.7,7.35,,9.56,65,,,percent of total billed charges,65% of total billed charges,10,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.94,20,,,percent of total billed charges,20% of total billed charges,2.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.94,20,,,percent of total billed charges,20% of total billed charges,2.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.56,65,,,percent of total billed charges,65% of total billed charges,9.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.94,53.67,
PRAMOXINE/ CALAMINE LOT,3500689,CDM,250,RC,J3490,HCPCS,outpatient,,,15.4,7.7,,10.01,65,,,percent of total billed charges,65% of total billed charges,10.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.08,20,,,percent of total billed charges,20% of total billed charges,3.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.08,20,,,percent of total billed charges,20% of total billed charges,3.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.01,65,,,percent of total billed charges,65% of total billed charges,10.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.08,53.67,
PRAVASTATIN TAB [20 MG],3500690,CDM,250,RC,J3490,HCPCS,outpatient,,,12.5,6.25,,8.13,65,,,percent of total billed charges,65% of total billed charges,8.5,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,20,,,percent of total billed charges,20% of total billed charges,2.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,20,,,percent of total billed charges,20% of total billed charges,2.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.13,65,,,percent of total billed charges,65% of total billed charges,8.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.5,53.67,
PRAVASTATIN TAB [40 MG],3500691,CDM,250,RC,J3490,HCPCS,outpatient,,,21.5,10.75,,13.98,65,,,percent of total billed charges,65% of total billed charges,14.62,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.3,20,,,percent of total billed charges,20% of total billed charges,4.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.3,20,,,percent of total billed charges,20% of total billed charges,4.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.98,65,,,percent of total billed charges,65% of total billed charges,13.98,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.3,53.67,
PREALBUMIN,3300887,CDM,301,RC,84134,HCPCS,outpatient,,,49.2,24.6,,31.98,65,,,percent of total billed charges,65% of total billed charges,33.46,68,,,percent of total billed charges,68% of total billed charges,20.7,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.84,20,,,percent of total billed charges,20% of total billed charges,9.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.84,20,,,percent of total billed charges,20% of total billed charges,9.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.98,65,,,percent of total billed charges,65% of total billed charges,31.98,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.84,33.46,
PREDNISOLONE 1% DRP [EYE],3500692,CDM,250,RC,J3490,HCPCS,outpatient,,,110.65,55.33,,71.92,65,,,percent of total billed charges,65% of total billed charges,75.24,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.13,20,,,percent of total billed charges,20% of total billed charges,22.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.13,20,,,percent of total billed charges,20% of total billed charges,22.13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.92,65,,,percent of total billed charges,65% of total billed charges,71.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66.39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.13,75.24,
PREDNISOLONE SOD PHOS LIQ,3501022,CDM,250,RC,J3490,HCPCS,outpatient,,,7.9,3.95,,5.14,65,,,percent of total billed charges,65% of total billed charges,5.37,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.58,20,,,percent of total billed charges,20% of total billed charges,1.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.58,20,,,percent of total billed charges,20% of total billed charges,1.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.14,65,,,percent of total billed charges,65% of total billed charges,5.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.58,53.67,
PREDNISONE TAB [20 MG],3500695,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PREDNISONE TAB [5 MG],3500696,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PREGABALIN CAP [100 MG],3501007,CDM,250,RC,J3490,HCPCS,outpatient,,,8.8,4.4,,5.72,65,,,percent of total billed charges,65% of total billed charges,5.98,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.76,20,,,percent of total billed charges,20% of total billed charges,1.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.76,20,,,percent of total billed charges,20% of total billed charges,1.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.72,65,,,percent of total billed charges,65% of total billed charges,5.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.76,53.67,
PREGABALIN CAP [25 MG],3500698,CDM,250,RC,J3490,HCPCS,outpatient,,,13.8,6.9,,8.97,65,,,percent of total billed charges,65% of total billed charges,9.38,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.76,20,,,percent of total billed charges,20% of total billed charges,2.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.76,20,,,percent of total billed charges,20% of total billed charges,2.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.97,65,,,percent of total billed charges,65% of total billed charges,8.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.76,53.67,
PREGABALIN CAP [50 MG],3500699,CDM,250,RC,J3490,HCPCS,outpatient,,,7.9,3.95,,5.14,65,,,percent of total billed charges,65% of total billed charges,5.37,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.58,20,,,percent of total billed charges,20% of total billed charges,1.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.58,20,,,percent of total billed charges,20% of total billed charges,1.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.14,65,,,percent of total billed charges,65% of total billed charges,5.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.58,53.67,
PREGABALIN CAP [75 MG],3500700,CDM,250,RC,J3490,HCPCS,outpatient,,,8.05,4.03,,5.23,65,,,percent of total billed charges,65% of total billed charges,5.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.61,20,,,percent of total billed charges,20% of total billed charges,1.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.61,20,,,percent of total billed charges,20% of total billed charges,1.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.23,65,,,percent of total billed charges,65% of total billed charges,5.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.61,53.67,
PREGNANCY TEST,3300769,CDM,307,RC,81025,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,8.98,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
PREP SITE F/S/N/H/F/G/M/D GT 1ST 100SQCM,3462070,CDM,982,RC,15004,HCPCS,outpatient,,,537,268.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,176.99,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,292.58,110,,,fee schedule,110% of Medicare physician fee schedule,292.58,110,,,fee schedule,110% of Medicare physician fee schedule,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,305.88,115,,,fee schedule,115% of Medicare physician fee schedule,229.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,336.46,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,176.99,336.46,
PREP SITE TRNK/ARM/LEG 1ST 100SQCM/1 PCT,3462069,CDM,982,RC,15002,HCPCS,outpatient,,,472,236,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,148.84,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,248.29,110,,,fee schedule,110% of Medicare physician fee schedule,248.29,110,,,fee schedule,110% of Medicare physician fee schedule,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,259.58,115,,,fee schedule,115% of Medicare physician fee schedule,201.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,285.54,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.84,285.54,
PREPARATION H SUPP,3501131,CDM,250,RC,,,outpatient,,,5.75,2.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
PRIMIDONE TAB [50 MG],3500701,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PRISMA 4-1/3 HEXAGAN STERILE,3521938,CDM,272,RC,,,outpatient,,,74.27,37.14,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.85,20,,,percent of total billed charges,20% of total billed charges,14.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.85,20,,,percent of total billed charges,20% of total billed charges,14.85,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.28,65,,,percent of total billed charges,65% of total billed charges,48.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.85,53.67,
PRO-STAT 64 [1 OZ PKT],3500710,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PROCAINAMIDE & NAPA,3300355,CDM,301,RC,80190,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,23.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
PROCALCITONIN,3300918,CDM,300,RC,84145,HCPCS,outpatient,,,343.5,171.75,,223.28,65,,,percent of total billed charges,65% of total billed charges,233.58,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.7,20,,,percent of total billed charges,20% of total billed charges,68.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.7,20,,,percent of total billed charges,20% of total billed charges,68.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,223.28,65,,,percent of total billed charges,65% of total billed charges,223.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,171.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,206.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.7,233.58,
PROCHLORPERAZINE INJ [10,3500702,CDM,636,RC,J0780,HCPCS,outpatient,,,99.9,49.95,,,,,,other,Not reimbursable per contract ,67.93,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.98,20,,,percent of total billed charges,20% of total billed charges,19.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.98,20,,,percent of total billed charges,20% of total billed charges,19.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.92,80,,,case rate,80% for high cost drug carve out,84.92,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,84.92,
PROCTOFOAM HC 1%,3501142,CDM,250,RC,,,outpatient,,,89.8,44.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.96,20,,,percent of total billed charges,20% of total billed charges,17.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.96,20,,,percent of total billed charges,20% of total billed charges,17.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.37,65,,,percent of total billed charges,65% of total billed charges,58.37,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.96,58.37,
PROGESTERONE,3300223,CDM,301,RC,84144,HCPCS,outpatient,,,81,40.5,,52.65,65,,,percent of total billed charges,65% of total billed charges,55.08,68,,,percent of total billed charges,68% of total billed charges,29.61,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,20,,,percent of total billed charges,20% of total billed charges,16.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,20,,,percent of total billed charges,20% of total billed charges,16.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.65,65,,,percent of total billed charges,65% of total billed charges,52.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,55.08,
PROLACTIN,3300153,CDM,301,RC,84146,HCPCS,outpatient,,,97,48.5,,63.05,65,,,percent of total billed charges,65% of total billed charges,65.96,68,,,percent of total billed charges,68% of total billed charges,27.5,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.05,65,,,percent of total billed charges,65% of total billed charges,63.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.4,65.96,
PROMETHAZINE INJ [25 MG/M,3500704,CDM,636,RC,J2550,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
PROMETHAZINE SUPP [12.5 M,3500705,CDM,250,RC,J3490,HCPCS,outpatient,,,117.05,58.53,,76.08,65,,,percent of total billed charges,65% of total billed charges,79.59,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.41,20,,,percent of total billed charges,20% of total billed charges,23.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.41,20,,,percent of total billed charges,20% of total billed charges,23.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.08,65,,,percent of total billed charges,65% of total billed charges,76.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,79.59,
PROMETHAZINE SUPP [25 MG],3500706,CDM,250,RC,J3490,HCPCS,outpatient,,,117.05,58.53,,76.08,65,,,percent of total billed charges,65% of total billed charges,79.59,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.41,20,,,percent of total billed charges,20% of total billed charges,23.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.41,20,,,percent of total billed charges,20% of total billed charges,23.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.08,65,,,percent of total billed charges,65% of total billed charges,76.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,79.59,
PROMETHAZINE TAB [25 MG],3500707,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PROPOFOL 500 MG/50ML,3501266,CDM,636,RC,J3490,HCPCS,outpatient,,,81,40.5,,,,,,other,Not reimbursable per contract ,55.08,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,20,,,percent of total billed charges,20% of total billed charges,16.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,20,,,percent of total billed charges,20% of total billed charges,16.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,80,,,case rate,80% for high cost drug carve out,68.85,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,68.85,
PROPRANOLOL 10 MG,3501152,CDM,250,RC,,,outpatient,,,3.53,1.77,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.71,20,,,percent of total billed charges,20% of total billed charges,0.71,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.71,20,,,percent of total billed charges,20% of total billed charges,0.71,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.29,65,,,percent of total billed charges,65% of total billed charges,2.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.71,53.67,
PROPRANOLOL TAB [20 MG],3500708,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PROPRANOLOL TAB [40 MG],3500709,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
PROSTAGLANDIN EACH,3300889,CDM,301,RC,84150,HCPCS,outpatient,,,31,15.5,,20.15,65,,,percent of total billed charges,65% of total billed charges,21.08,68,,,percent of total billed charges,68% of total billed charges,35.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.15,65,,,percent of total billed charges,65% of total billed charges,20.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.2,35.43,
PROSTHETIC TR /15MIN,3600017,CDM,420,RC,97761,HCPCS,outpatient,,,110,55,,71.5,65,,,percent of total billed charges,65% of total billed charges,74.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.5,65,,,percent of total billed charges,65% of total billed charges,71.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22,82,
PROTEIN ELECTRPHRSIS SER,3300101,CDM,301,RC,84165,HCPCS,outpatient,,,75,37.5,,48.75,65,,,percent of total billed charges,65% of total billed charges,51,68,,,percent of total billed charges,68% of total billed charges,15.25,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,20,,,percent of total billed charges,20% of total billed charges,15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.75,65,,,percent of total billed charges,65% of total billed charges,48.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,51,
PROTEIN S & C PANEL,3300659,CDM,305,RC,85303,HCPCS,outpatient,,,334,167,,217.1,65,,,percent of total billed charges,65% of total billed charges,227.12,68,,,percent of total billed charges,68% of total billed charges,19.63,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.8,20,,,percent of total billed charges,20% of total billed charges,66.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.8,20,,,percent of total billed charges,20% of total billed charges,66.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,217.1,65,,,percent of total billed charges,65% of total billed charges,217.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,167,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.63,227.12,
PROTEIN URINE (RAN),3300461,CDM,301,RC,84156,HCPCS,outpatient,,,32,16,,20.8,65,,,percent of total billed charges,65% of total billed charges,21.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.4,20,,,percent of total billed charges,20% of total billed charges,6.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.4,20,,,percent of total billed charges,20% of total billed charges,6.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.8,65,,,percent of total billed charges,65% of total billed charges,20.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.4,21.76,
PROTHROMBIN TIME,3300649,CDM,305,RC,85610,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,5.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.58,40.8,
PROTONIX IV [40 MG],3501018,CDM,250,RC,J3490,HCPCS,outpatient,,,27,13.5,,17.55,65,,,percent of total billed charges,65% of total billed charges,18.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,20,,,percent of total billed charges,20% of total billed charges,5.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,20,,,percent of total billed charges,20% of total billed charges,5.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.55,65,,,percent of total billed charges,65% of total billed charges,17.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,53.67,
PSA DIAGNOSTIC,3300183,CDM,301,RC,84153,HCPCS,outpatient,,,81,40.5,,52.65,65,,,percent of total billed charges,65% of total billed charges,55.08,68,,,percent of total billed charges,68% of total billed charges,26.11,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,20,,,percent of total billed charges,20% of total billed charges,16.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.2,20,,,percent of total billed charges,20% of total billed charges,16.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.65,65,,,percent of total billed charges,65% of total billed charges,52.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.2,55.08,
PSA FREE,3300325,CDM,301,RC,84154,HCPCS,outpatient,,,97,48.5,,63.05,65,,,percent of total billed charges,65% of total billed charges,65.96,68,,,percent of total billed charges,68% of total billed charges,25.42,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.4,20,,,percent of total billed charges,20% of total billed charges,19.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.05,65,,,percent of total billed charges,65% of total billed charges,63.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.4,65.96,
PSA SCREENING,3300797,CDM,309,RC,G0103,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
PT EVALUATION HIGH COMPEXITY,3600090,CDM,420,RC,97163,HCPCS,outpatient,,,391,195.5,,254.15,65,,,percent of total billed charges,65% of total billed charges,265.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.2,20,,,percent of total billed charges,20% of total billed charges,78.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.2,20,,,percent of total billed charges,20% of total billed charges,78.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,254.15,65,,,percent of total billed charges,65% of total billed charges,254.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,234.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78.2,265.88,
PT EVALUATION LOW COMPLEXITY,3600023,CDM,420,RC,97161,HCPCS,outpatient,,,291,145.5,,189.15,65,,,percent of total billed charges,65% of total billed charges,197.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,20,,,percent of total billed charges,20% of total billed charges,58.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,20,,,percent of total billed charges,20% of total billed charges,58.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.15,65,,,percent of total billed charges,65% of total billed charges,189.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.2,197.88,
PT EVALUATION MODERATE COMPLEXITY,3600089,CDM,420,RC,97162,HCPCS,outpatient,,,341,170.5,,221.65,65,,,percent of total billed charges,65% of total billed charges,231.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.2,20,,,percent of total billed charges,20% of total billed charges,68.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.2,20,,,percent of total billed charges,20% of total billed charges,68.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,221.65,65,,,percent of total billed charges,65% of total billed charges,221.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,68.2,231.88,
PULSE OX CONTIN OVERNIGHT,3170093,CDM,460,RC,94762,HCPCS,outpatient,,,249,124.5,,161.85,65,,,percent of total billed charges,65% of total billed charges,169.32,68,,,percent of total billed charges,68% of total billed charges,93.57,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,20,,,percent of total billed charges,20% of total billed charges,49.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,20,,,percent of total billed charges,20% of total billed charges,49.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,161.85,65,,,percent of total billed charges,65% of total billed charges,161.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,149.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,207,
PULSE OXEMETER,3060007,CDM,271,RC,,,outpatient,,,68,34,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.6,53.67,
PUNCTURE ASPIR ABSC HEMATOMA BULLA/CYSTS,3462049,CDM,982,RC,10160,HCPCS,outpatient,,,172,86,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.38,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.94,110,,,fee schedule,110% of Medicare physician fee schedule,106.94,110,,,fee schedule,110% of Medicare physician fee schedule,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.8,115,,,fee schedule,115% of Medicare physician fee schedule,116.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.98,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.38,122.98,
PURACOL PLUS AGT,6215810,CDM,272,RC,,,outpatient,,,70.21,35.11,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.64,65,,,percent of total billed charges,65% of total billed charges,45.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.04,53.67,
PUREWICK FEMALE CATH,3250376,CDM,272,RC,,,outpatient,,,44.1,22.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.82,20,,,percent of total billed charges,20% of total billed charges,8.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.82,20,,,percent of total billed charges,20% of total billed charges,8.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.67,65,,,percent of total billed charges,65% of total billed charges,28.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.82,53.67,
PYSI THERAPY RE EVAL,3600025,CDM,424,RC,97164,HCPCS,outpatient,,,146,73,,94.9,65,,,percent of total billed charges,65% of total billed charges,99.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.2,20,,,percent of total billed charges,20% of total billed charges,29.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.2,20,,,percent of total billed charges,20% of total billed charges,29.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.9,65,,,percent of total billed charges,65% of total billed charges,94.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.2,99.28,
Q Digoxin,3300940,CDM,300,RC,80162,HCPCS,outpatient,,,12,6,,7.8,65,,,percent of total billed charges,65% of total billed charges,8.16,68,,,percent of total billed charges,68% of total billed charges,18.85,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.8,65,,,percent of total billed charges,65% of total billed charges,7.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,18.85,
QUANTIFERON TB GOLD TEST,3300240,CDM,301,RC,86480,HCPCS,outpatient,,,120,60,,78,65,,,percent of total billed charges,65% of total billed charges,81.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,65,,,percent of total billed charges,65% of total billed charges,78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,81.6,
QuantiFERON-TB Gold Plus,3300938,CDM,300,RC,86480,HCPCS,outpatient,,,55,27.5,,35.75,65,,,percent of total billed charges,65% of total billed charges,37.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.75,65,,,percent of total billed charges,65% of total billed charges,35.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11,37.4,
QUANTITIVE HCG,3300249,CDM,301,RC,84702,HCPCS,outpatient,,,83,41.5,,53.95,65,,,percent of total billed charges,65% of total billed charges,56.44,68,,,percent of total billed charges,68% of total billed charges,21.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.6,20,,,percent of total billed charges,20% of total billed charges,16.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.95,65,,,percent of total billed charges,65% of total billed charges,53.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.6,56.44,
Quest-SARS-CoV-2 COVID-19,3300906,CDM,306,RC,87635,HCPCS,outpatient,,,867.74,433.87,,564.03,65,,,percent of total billed charges,65% of total billed charges,590.06,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,173.55,20,,,percent of total billed charges,20% of total billed charges,173.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,173.55,20,,,percent of total billed charges,20% of total billed charges,173.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,564.03,65,,,percent of total billed charges,65% of total billed charges,564.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,433.87,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,520.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.55,590.06,
QUETIAPINE FUM TAB [100 M,3500714,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
QUETIAPINE TAB [25 MG],3500715,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
QUETIAPINE TAB [300 MG],3500716,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
QUETIAPINE TAB [400 MG],3500717,CDM,250,RC,J3490,HCPCS,outpatient,,,131.8,65.9,,85.67,65,,,percent of total billed charges,65% of total billed charges,89.62,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.36,20,,,percent of total billed charges,20% of total billed charges,26.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.36,20,,,percent of total billed charges,20% of total billed charges,26.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.67,65,,,percent of total billed charges,65% of total billed charges,85.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.36,89.62,
QUETIAPINE TAB [50 MG],3500718,CDM,250,RC,J3490,HCPCS,outpatient,,,32.85,16.43,,21.35,65,,,percent of total billed charges,65% of total billed charges,22.34,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,20,,,percent of total billed charges,20% of total billed charges,6.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,20,,,percent of total billed charges,20% of total billed charges,6.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.35,65,,,percent of total billed charges,65% of total billed charges,21.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,53.67,
QUINIDINE,3300185,CDM,301,RC,80194,HCPCS,outpatient,,,87,43.5,,56.55,65,,,percent of total billed charges,65% of total billed charges,59.16,68,,,percent of total billed charges,68% of total billed charges,20.72,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.4,20,,,percent of total billed charges,20% of total billed charges,17.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.4,20,,,percent of total billed charges,20% of total billed charges,17.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.55,65,,,percent of total billed charges,65% of total billed charges,56.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.4,59.16,
R N P,3300579,CDM,302,RC,86235,HCPCS,outpatient,,,112,56,,72.8,65,,,percent of total billed charges,65% of total billed charges,76.16,68,,,percent of total billed charges,68% of total billed charges,25.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.8,65,,,percent of total billed charges,65% of total billed charges,72.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,76.16,
RA RHEUMATOID QUAN,3300489,CDM,302,RC,86431,HCPCS,outpatient,,,47,23.5,,30.55,65,,,percent of total billed charges,65% of total billed charges,31.96,68,,,percent of total billed charges,68% of total billed charges,8.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.4,20,,,percent of total billed charges,20% of total billed charges,9.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.4,20,,,percent of total billed charges,20% of total billed charges,9.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.55,65,,,percent of total billed charges,65% of total billed charges,30.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.06,31.96,
RADICAL ART TRAY 20X3,6215877,CDM,272,RC,,,outpatient,,,464.7,232.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.94,20,,,percent of total billed charges,20% of total billed charges,92.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.94,20,,,percent of total billed charges,20% of total billed charges,92.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.06,65,,,percent of total billed charges,65% of total billed charges,302.06,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,278.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,302.06,
RALOXIFENE TAB [60 MG],3500719,CDM,250,RC,J3490,HCPCS,outpatient,,,35.6,17.8,,23.14,65,,,percent of total billed charges,65% of total billed charges,24.21,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.12,20,,,percent of total billed charges,20% of total billed charges,7.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.12,20,,,percent of total billed charges,20% of total billed charges,7.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.14,65,,,percent of total billed charges,65% of total billed charges,23.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.12,53.67,
RAMIPRIL CAP [10 MG],3500720,CDM,250,RC,J3490,HCPCS,outpatient,,,11.85,5.93,,7.7,65,,,percent of total billed charges,65% of total billed charges,8.06,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.37,20,,,percent of total billed charges,20% of total billed charges,2.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.37,20,,,percent of total billed charges,20% of total billed charges,2.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.7,65,,,percent of total billed charges,65% of total billed charges,7.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.37,53.67,
RAMIPRIL CAP [2.5 MG],3500721,CDM,250,RC,J3490,HCPCS,outpatient,,,9.05,4.53,,5.88,65,,,percent of total billed charges,65% of total billed charges,6.15,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.81,20,,,percent of total billed charges,20% of total billed charges,1.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.81,20,,,percent of total billed charges,20% of total billed charges,1.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.88,65,,,percent of total billed charges,65% of total billed charges,5.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.81,53.67,
RAMIPRIL CAP [5 MG],3500722,CDM,250,RC,J3490,HCPCS,outpatient,,,9,4.5,,5.85,65,,,percent of total billed charges,65% of total billed charges,6.12,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,20,,,percent of total billed charges,20% of total billed charges,1.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,20,,,percent of total billed charges,20% of total billed charges,1.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.85,65,,,percent of total billed charges,65% of total billed charges,5.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,53.67,
RANITIDINE TAB [150 MG],3501017,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
RANOLAZINE TAB [500 MG],3501015,CDM,250,RC,J3490,HCPCS,outpatient,,,32.15,16.08,,20.9,65,,,percent of total billed charges,65% of total billed charges,21.86,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.43,20,,,percent of total billed charges,20% of total billed charges,6.43,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.43,20,,,percent of total billed charges,20% of total billed charges,6.43,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.9,65,,,percent of total billed charges,65% of total billed charges,20.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.43,53.67,
RAPID BETA STREP SCR,3300717,CDM,306,RC,87430,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
RAPID COVID-19 ANTIGEN,3300930,CDM,302,RC,87426,HCPCS,outpatient,,,162,81,,105.3,65,,,percent of total billed charges,65% of total billed charges,110.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,20,,,percent of total billed charges,20% of total billed charges,32.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.4,20,,,percent of total billed charges,20% of total billed charges,32.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.3,65,,,percent of total billed charges,65% of total billed charges,105.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.4,110.16,
RAPID EPISTAXIS RHINO,2000142,CDM,272,RC,,,outpatient,,,283.4,141.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.68,20,,,percent of total billed charges,20% of total billed charges,56.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.68,20,,,percent of total billed charges,20% of total billed charges,56.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,184.21,65,,,percent of total billed charges,65% of total billed charges,184.21,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,170.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,184.21,
RAST ALLERGY GROUP,3300535,CDM,302,RC,86005,HCPCS,outpatient,,,84,42,,54.6,65,,,percent of total billed charges,65% of total billed charges,57.12,68,,,percent of total billed charges,68% of total billed charges,11.32,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,20,,,percent of total billed charges,20% of total billed charges,16.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.6,65,,,percent of total billed charges,65% of total billed charges,54.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.32,57.12,
RAST SALAD GROUP,3300531,CDM,302,RC,86003,HCPCS,outpatient,,,168,84,,109.2,65,,,percent of total billed charges,65% of total billed charges,114.24,68,,,percent of total billed charges,68% of total billed charges,7.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.2,65,,,percent of total billed charges,65% of total billed charges,109.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.41,114.24,
RAST SINGLE TEST IGE,3300591,CDM,302,RC,86003,HCPCS,outpatient,,,53,26.5,,34.45,65,,,percent of total billed charges,65% of total billed charges,36.04,68,,,percent of total billed charges,68% of total billed charges,7.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.6,20,,,percent of total billed charges,20% of total billed charges,10.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.6,20,,,percent of total billed charges,20% of total billed charges,10.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.45,65,,,percent of total billed charges,65% of total billed charges,34.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.41,36.04,
RAST SOUTHEAST REGIO,3300529,CDM,302,RC,86003,HCPCS,outpatient,,,299,149.5,,194.35,65,,,percent of total billed charges,65% of total billed charges,203.32,68,,,percent of total billed charges,68% of total billed charges,7.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,20,,,percent of total billed charges,20% of total billed charges,59.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.8,20,,,percent of total billed charges,20% of total billed charges,59.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,194.35,65,,,percent of total billed charges,65% of total billed charges,194.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,149.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.41,203.32,
RAST VEGETABLE GROUP,3300533,CDM,302,RC,86003,HCPCS,outpatient,,,168,84,,109.2,65,,,percent of total billed charges,65% of total billed charges,114.24,68,,,percent of total billed charges,68% of total billed charges,7.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.2,65,,,percent of total billed charges,65% of total billed charges,109.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.41,114.24,
RAYTEC SPONGE 4X4 10 PK,6215797,CDM,272,RC,,,outpatient,,,7.72,3.86,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.54,20,,,percent of total billed charges,20% of total billed charges,1.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.54,20,,,percent of total billed charges,20% of total billed charges,1.54,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.02,65,,,percent of total billed charges,65% of total billed charges,5.02,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.54,53.67,
RAYTEX GAUZE,3060149,CDM,272,RC,,,outpatient,,,6.8,3.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.36,20,,,percent of total billed charges,20% of total billed charges,1.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.36,20,,,percent of total billed charges,20% of total billed charges,1.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.42,65,,,percent of total billed charges,65% of total billed charges,4.42,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.36,53.67,
RECOVERY ROOM 1ST HOUR,3060261,CDM,360,RC,,,outpatient,,,602,301,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.4,20,,,percent of total billed charges,20% of total billed charges,120.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.4,20,,,percent of total billed charges,20% of total billed charges,120.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,391.3,65,,,percent of total billed charges,65% of total billed charges,391.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210.7,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,361.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,391.3,
RECOVERY ROOM ADDL 1/2 HOUR,3060262,CDM,360,RC,,,outpatient,,,274,137,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.8,20,,,percent of total billed charges,20% of total billed charges,54.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.8,20,,,percent of total billed charges,20% of total billed charges,54.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178.1,65,,,percent of total billed charges,65% of total billed charges,178.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.9,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,164.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,178.1,
RECOVERY-OTH SED 15/MIN,3060280,CDM,710,RC,,,outpatient,,,144,72,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,20,,,percent of total billed charges,20% of total billed charges,28.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.8,20,,,percent of total billed charges,20% of total billed charges,28.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.6,65,,,percent of total billed charges,65% of total billed charges,93.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,86.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.8,93.6,
RED CELL UNIT,3300929,CDM,390,RC,P9016,HCPCS,outpatient,,,416.5,208.25,,270.73,65,,,percent of total billed charges,65% of total billed charges,283.22,68,,,percent of total billed charges,68% of total billed charges,104,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.3,20,,,percent of total billed charges,20% of total billed charges,83.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.3,20,,,percent of total billed charges,20% of total billed charges,83.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,270.73,65,,,percent of total billed charges,65% of total billed charges,270.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,283.22,
REFERENCE DRAW FEE QUEST/LABCORP,3300922,CDM,300,RC,36415,HCPCS,outpatient,,,12,6,,7.8,65,,,percent of total billed charges,65% of total billed charges,8.16,68,,,percent of total billed charges,68% of total billed charges,3,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.8,65,,,percent of total billed charges,65% of total billed charges,7.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,8.16,
REGENERON INFUSION,3040032,CDM,771,RC,M0244,HCPCS,outpatient,,,450,225,,292.5,65,,,percent of total billed charges,65% of total billed charges,306,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,20,,,percent of total billed charges,20% of total billed charges,90,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,20,,,percent of total billed charges,20% of total billed charges,90,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,292.5,65,,,percent of total billed charges,65% of total billed charges,292.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,270,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85,306,
REMDESIVIR  100 MG/VIAL,3521952,CDM,636,RC,J3490,HCPCS,outpatient,,,904.8,452.4,,588.12,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,615.26,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180.96,20,,,percent of total billed charges,20% of total billed charges,180.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180.96,20,,,percent of total billed charges,20% of total billed charges,180.96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,723.84,80,,,case rate,80% for high cost drug carve out,769.08,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,542.88,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180.96,769.08,
REMOVAL NAIL PLATE ADD-ON,3700284,CDM,510,RC,11732,HCPCS,outpatient,,,152,76,,98.8,65,,,percent of total billed charges,65% of total billed charges,103.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.4,20,,,percent of total billed charges,20% of total billed charges,30.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.4,20,,,percent of total billed charges,20% of total billed charges,30.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98.8,65,,,percent of total billed charges,65% of total billed charges,98.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.4,178,
REMOVAL NAIL PLATE SIMPLE,3700310,CDM,983,RC,11730,HCPCS,outpatient,,,175,87.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.96,110,,,fee schedule,110% of Medicare physician fee schedule,59.96,110,,,fee schedule,110% of Medicare physician fee schedule,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.69,115,,,fee schedule,115% of Medicare physician fee schedule,88.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.22,88.82,
RENAL FUNCTION PANEL,3300365,CDM,301,RC,80069,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,102,
RENIN,3300143,CDM,301,RC,84244,HCPCS,outpatient,,,127,63.5,,82.55,65,,,percent of total billed charges,65% of total billed charges,86.36,68,,,percent of total billed charges,68% of total billed charges,31.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.4,20,,,percent of total billed charges,20% of total billed charges,25.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.4,20,,,percent of total billed charges,20% of total billed charges,25.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.55,65,,,percent of total billed charges,65% of total billed charges,82.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.4,86.36,
REPAIR 1ST ABD WALL HERNIA,3462015,CDM,982,RC,49560,HCPCS,outpatient,,,1052,526,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,529.16,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,581.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,529.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,529.16,581.76,
RESCUENET RETRIEVAL NET,3060312,CDM,272,RC,,,outpatient,,,435.2,217.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.04,20,,,percent of total billed charges,20% of total billed charges,87.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.04,20,,,percent of total billed charges,20% of total billed charges,87.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,282.88,65,,,percent of total billed charges,65% of total billed charges,282.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,282.88,
RESOLUTION CLIP,3060171,CDM,278,RC,,,both,,,760,380,,,,,,other,Not reimbursable per contract ,516.8,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152,20,,,percent of total billed charges,20% of total billed charges,152,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152,20,,,percent of total billed charges,20% of total billed charges,152,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,608,80,,,case rate,80% for implant carve out,646,85,,,case rate,85% for implant carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,456,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,646,
RESPIRATORY PATHOGEN PANEL,3300798,CDM,302,RC,87633,HCPCS,outpatient,,,1027.04,513.52,,667.58,65,,,percent of total billed charges,65% of total billed charges,698.39,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.41,20,,,percent of total billed charges,20% of total billed charges,205.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.41,20,,,percent of total billed charges,20% of total billed charges,205.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,667.58,65,,,percent of total billed charges,65% of total billed charges,667.58,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,513.52,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,616.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,205.41,698.39,
RESPIRATORY VIRUS PROFILE,3300520,CDM,302,RC,87633,HCPCS,outpatient,,,735,367.5,,477.75,65,,,percent of total billed charges,65% of total billed charges,499.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147,20,,,percent of total billed charges,20% of total billed charges,147,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147,20,,,percent of total billed charges,20% of total billed charges,147,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,477.75,65,,,percent of total billed charges,65% of total billed charges,477.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,367.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,441,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,499.8,
RESTRAINT BODY LG,3250107,CDM,271,RC,,,outpatient,,,104.5,52.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.9,20,,,percent of total billed charges,20% of total billed charges,20.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.9,20,,,percent of total billed charges,20% of total billed charges,20.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.93,65,,,percent of total billed charges,65% of total billed charges,67.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.9,67.93,
RESTRAINT BODY VEST,3250111,CDM,271,RC,,,outpatient,,,102,51,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,20,,,percent of total billed charges,20% of total billed charges,20.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,20,,,percent of total billed charges,20% of total billed charges,20.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.3,65,,,percent of total billed charges,65% of total billed charges,66.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,66.3,
RESTRAINT BODY VEST XL,3250106,CDM,271,RC,,,outpatient,,,74.5,37.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.9,20,,,percent of total billed charges,20% of total billed charges,14.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.9,20,,,percent of total billed charges,20% of total billed charges,14.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.43,65,,,percent of total billed charges,65% of total billed charges,48.43,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.9,53.67,
RESTRAINT LIMB,3250145,CDM,271,RC,,,outpatient,,,72.45,36.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.49,20,,,percent of total billed charges,20% of total billed charges,14.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.49,20,,,percent of total billed charges,20% of total billed charges,14.49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.09,65,,,percent of total billed charges,65% of total billed charges,47.09,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.49,53.67,
RESTRAINTS/ MITTEN CONTROL,3250108,CDM,271,RC,,,outpatient,,,26.21,13.11,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.24,20,,,percent of total billed charges,20% of total billed charges,5.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.24,20,,,percent of total billed charges,20% of total billed charges,5.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.04,65,,,percent of total billed charges,65% of total billed charges,17.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.24,53.67,
RETICULOCYTE,3300651,CDM,305,RC,85044,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,6.1,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
RH BLOOD TYPE,3300781,CDM,309,RC,86901,HCPCS,outpatient,,,28,14,,18.2,65,,,percent of total billed charges,65% of total billed charges,19.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.6,20,,,percent of total billed charges,20% of total billed charges,5.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.6,20,,,percent of total billed charges,20% of total billed charges,5.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.2,65,,,percent of total billed charges,65% of total billed charges,18.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.6,19.04,
RHINO ROCKET NASAL MED,3250276,CDM,272,RC,,,outpatient,,,80.76,40.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.15,20,,,percent of total billed charges,20% of total billed charges,16.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.15,20,,,percent of total billed charges,20% of total billed charges,16.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.49,65,,,percent of total billed charges,65% of total billed charges,52.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.15,53.67,
"RHINO ROCKET, LARGE",3521932,CDM,272,RC,,,outpatient,,,129.03,64.52,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.81,20,,,percent of total billed charges,20% of total billed charges,25.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.81,20,,,percent of total billed charges,20% of total billed charges,25.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.87,65,,,percent of total billed charges,65% of total billed charges,83.87,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.81,83.87,
"RHINO ROCKET, SMALL",3521933,CDM,272,RC,,,outpatient,,,117.48,58.74,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.5,20,,,percent of total billed charges,20% of total billed charges,23.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.5,20,,,percent of total billed charges,20% of total billed charges,23.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.36,65,,,percent of total billed charges,65% of total billed charges,76.36,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.5,76.36,
RIB BELT UNIVERSAL,3250183,CDM,271,RC,,,outpatient,,,54.05,27.03,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.81,20,,,percent of total billed charges,20% of total billed charges,10.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.81,20,,,percent of total billed charges,20% of total billed charges,10.81,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.13,65,,,percent of total billed charges,65% of total billed charges,35.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.81,53.67,
RIBS 3VW INC PA CHES,3400012,CDM,320,RC,71101,HCPCS,outpatient,,,192,96,,124.8,65,,,percent of total billed charges,65% of total billed charges,130.56,68,,,percent of total billed charges,68% of total billed charges,22.37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.4,20,,,percent of total billed charges,20% of total billed charges,38.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.4,20,,,percent of total billed charges,20% of total billed charges,38.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,124.8,65,,,percent of total billed charges,65% of total billed charges,124.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.37,180,
RIBS 3VW INC PA CHES,3400066,CDM,320,RC,71101,HCPCS,outpatient,,,211,105.5,,137.15,65,,,percent of total billed charges,65% of total billed charges,143.48,68,,,percent of total billed charges,68% of total billed charges,22.37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.2,20,,,percent of total billed charges,20% of total billed charges,42.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.2,20,,,percent of total billed charges,20% of total billed charges,42.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.15,65,,,percent of total billed charges,65% of total billed charges,137.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.37,180,
RIBS 3VW INCL PA CHE,3440033,CDM,972,RC,71101,HCPCS,outpatient,,,71.5,35.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.98,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.47,110,,,fee schedule,110% of Medicare physician fee schedule,45.47,110,,,fee schedule,110% of Medicare physician fee schedule,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,223.94,115,,,fee schedule,115% of Medicare physician fee schedule,72.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.98,223.94,
RIBS 4VW  BILAT INC PA CHEST,3440486,CDM,972,RC,71111,HCPCS,outpatient,,,53,26.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.04,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.64,110,,,fee schedule,110% of Medicare physician fee schedule,56.64,110,,,fee schedule,110% of Medicare physician fee schedule,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.61,115,,,fee schedule,115% of Medicare physician fee schedule,78.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,26.04,235.61,
RIBS 4VW INC PA CHEST BILAT,3400013,CDM,320,RC,71111,HCPCS,outpatient,,,263,131.5,,170.95,65,,,percent of total billed charges,65% of total billed charges,178.84,68,,,percent of total billed charges,68% of total billed charges,30.04,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.6,20,,,percent of total billed charges,20% of total billed charges,52.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.6,20,,,percent of total billed charges,20% of total billed charges,52.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.95,65,,,percent of total billed charges,65% of total billed charges,170.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.04,180,
RIBS BIL MIN 3 V,3440031,CDM,972,RC,71110,HCPCS,outpatient,,,159.5,79.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.28,110,,,fee schedule,110% of Medicare physician fee schedule,47.28,110,,,fee schedule,110% of Medicare physician fee schedule,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.83,115,,,fee schedule,115% of Medicare physician fee schedule,73.18,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.58,225.83,
RIBS RT,3440035,CDM,972,RC,71101,HCPCS,outpatient,,,71.5,35.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.98,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.47,110,,,fee schedule,110% of Medicare physician fee schedule,45.47,110,,,fee schedule,110% of Medicare physician fee schedule,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,223.94,115,,,fee schedule,115% of Medicare physician fee schedule,72.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,52.3,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.98,223.94,
RIFAMPIN CAP [300 MG],3500723,CDM,250,RC,J3490,HCPCS,outpatient,,,23,11.5,,14.95,65,,,percent of total billed charges,65% of total billed charges,15.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.95,65,,,percent of total billed charges,65% of total billed charges,14.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.6,53.67,
RISPERIDONE TAB [0.25 MG],3500725,CDM,250,RC,J3490,HCPCS,outpatient,,,17.95,8.98,,11.67,65,,,percent of total billed charges,65% of total billed charges,12.21,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.59,20,,,percent of total billed charges,20% of total billed charges,3.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.59,20,,,percent of total billed charges,20% of total billed charges,3.59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.67,65,,,percent of total billed charges,65% of total billed charges,11.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.77,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.59,53.67,
RISPERIDONE TAB [0.5 MG],3500952,CDM,250,RC,J3490,HCPCS,outpatient,,,19.7,9.85,,12.81,65,,,percent of total billed charges,65% of total billed charges,13.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.94,20,,,percent of total billed charges,20% of total billed charges,3.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.94,20,,,percent of total billed charges,20% of total billed charges,3.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.81,65,,,percent of total billed charges,65% of total billed charges,12.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.94,53.67,
RISPERIDONE TAB [1 MG],3500726,CDM,250,RC,J3490,HCPCS,outpatient,,,22.85,11.43,,14.85,65,,,percent of total billed charges,65% of total billed charges,15.54,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.57,20,,,percent of total billed charges,20% of total billed charges,4.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.57,20,,,percent of total billed charges,20% of total billed charges,4.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.85,65,,,percent of total billed charges,65% of total billed charges,14.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.57,53.67,
RIVASTIGMINE PAT [4.6 MG],3500727,CDM,250,RC,J3490,HCPCS,outpatient,,,118.75,59.38,,77.19,65,,,percent of total billed charges,65% of total billed charges,80.75,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.75,20,,,percent of total billed charges,20% of total billed charges,23.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.75,20,,,percent of total billed charges,20% of total billed charges,23.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.19,65,,,percent of total billed charges,65% of total billed charges,77.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,71.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.75,80.75,
ROCKY MOUNT SPOT FEV,3300601,CDM,302,RC,86000,HCPCS,outpatient,,,98,49,,63.7,65,,,percent of total billed charges,65% of total billed charges,66.64,68,,,percent of total billed charges,68% of total billed charges,9.91,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.7,65,,,percent of total billed charges,65% of total billed charges,63.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.91,66.64,
ROCURONIUM BROMIDE 50MG/5ML,3501156,CDM,250,RC,,,outpatient,,,25.35,12.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,20,,,percent of total billed charges,20% of total billed charges,5.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.07,20,,,percent of total billed charges,20% of total billed charges,5.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.48,65,,,percent of total billed charges,65% of total billed charges,16.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.07,53.67,
ROOM-BOARD,3020003,CDM,110,RC,,,inpatient,,,577.5,288.75,,1750,100,,,per diem,"1750 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2600 for 2 days with a per diem after of 1000 or 3600 for 4 days with a per diem after of 1000. It can also pay at a er diem rate of 600, 1500 or 650 if non med/surg procedures are performed",1837,100,,,per diem,"1837 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2730 for 2 days with a per diem after of 1050 or 3780 for 4 days with a per diem after of 1050. It can also pay at a er diem rate of 630, 1575 or 683 if non med/surg procedures are performed",,,,,other,Not separately reimbursable for physician per contract terms,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,115.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,115.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,115.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,115.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,MS-DRG,,other,Pays at CMS DRG weights with UHC base rate markup. See MS-DRG rows. Can also pay at per diem rate of 1200 for rehab or SNF,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,115.5,1837,
ROPINIROLE TAB [0.25 MG],3500729,CDM,250,RC,J3490,HCPCS,outpatient,,,21.75,10.88,,14.14,65,,,percent of total billed charges,65% of total billed charges,14.79,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.35,20,,,percent of total billed charges,20% of total billed charges,4.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.35,20,,,percent of total billed charges,20% of total billed charges,4.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.14,65,,,percent of total billed charges,65% of total billed charges,14.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.35,53.67,
ROPINIROLE TAB [0.5 MG],3500730,CDM,250,RC,J3490,HCPCS,outpatient,,,12.5,6.25,,8.13,65,,,percent of total billed charges,65% of total billed charges,8.5,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,20,,,percent of total billed charges,20% of total billed charges,2.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,20,,,percent of total billed charges,20% of total billed charges,2.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.13,65,,,percent of total billed charges,65% of total billed charges,8.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.5,53.67,
ROPINIROLE TAB [1 MG],3500731,CDM,250,RC,J3490,HCPCS,outpatient,,,12.5,6.25,,8.13,65,,,percent of total billed charges,65% of total billed charges,8.5,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,20,,,percent of total billed charges,20% of total billed charges,2.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,20,,,percent of total billed charges,20% of total billed charges,2.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.13,65,,,percent of total billed charges,65% of total billed charges,8.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.5,53.67,
ROTAVIRUS ANTIGEN,3300737,CDM,306,RC,87425,HCPCS,outpatient,,,106,53,,68.9,65,,,percent of total billed charges,65% of total billed charges,72.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.2,20,,,percent of total billed charges,20% of total billed charges,21.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.2,20,,,percent of total billed charges,20% of total billed charges,21.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.9,65,,,percent of total billed charges,65% of total billed charges,68.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.2,72.08,
RP COMP 2.6-7.5 FACE,3231031,CDM,450,RC,12032,HCPCS,outpatient,,,1001,500.5,,650.65,65,,,percent of total billed charges,65% of total billed charges,680.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,200.2,20,,,percent of total billed charges,20% of total billed charges,200.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,200.2,20,,,percent of total billed charges,20% of total billed charges,200.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,650.65,65,,,percent of total billed charges,65% of total billed charges,650.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,600.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,680.68,
RP COMP 2.6-7.5 TRK,3231033,CDM,450,RC,12032,HCPCS,outpatient,,,503,251.5,,326.95,65,,,percent of total billed charges,65% of total billed charges,342.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.6,20,,,percent of total billed charges,20% of total billed charges,100.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.6,20,,,percent of total billed charges,20% of total billed charges,100.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,326.95,65,,,percent of total billed charges,65% of total billed charges,326.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,301.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,342.04,
RP INT 2.6-5.0 FACE,3231027,CDM,450,RC,12052,HCPCS,outpatient,,,401,200.5,,260.65,65,,,percent of total billed charges,65% of total billed charges,272.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.2,20,,,percent of total billed charges,20% of total billed charges,80.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.2,20,,,percent of total billed charges,20% of total billed charges,80.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,260.65,65,,,percent of total billed charges,65% of total billed charges,260.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,240.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,272.68,
RP INT 2.6-7.5 SCALP,3231021,CDM,450,RC,12032,HCPCS,outpatient,,,326,163,,211.9,65,,,percent of total billed charges,65% of total billed charges,221.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.2,20,,,percent of total billed charges,20% of total billed charges,65.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.2,20,,,percent of total billed charges,20% of total billed charges,65.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,211.9,65,,,percent of total billed charges,65% of total billed charges,211.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,195.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,221.68,
RP INT 5.1-7.5 FACE,3231029,CDM,450,RC,12053,HCPCS,outpatient,,,488,244,,317.2,65,,,percent of total billed charges,65% of total billed charges,331.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.6,20,,,percent of total billed charges,20% of total billed charges,97.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.6,20,,,percent of total billed charges,20% of total billed charges,97.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,317.2,65,,,percent of total billed charges,65% of total billed charges,317.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,292.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,331.84,
RP INT 7.6-12.5 SCLP,3231023,CDM,450,RC,12034,HCPCS,outpatient,,,396,198,,257.4,65,,,percent of total billed charges,65% of total billed charges,269.28,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.2,20,,,percent of total billed charges,20% of total billed charges,79.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.2,20,,,percent of total billed charges,20% of total billed charges,79.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,257.4,65,,,percent of total billed charges,65% of total billed charges,257.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,237.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,419,
RP INT TO 2.5 SCALP,3231019,CDM,450,RC,12031,HCPCS,outpatient,,,230,115,,149.5,65,,,percent of total billed charges,65% of total billed charges,156.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46,20,,,percent of total billed charges,20% of total billed charges,46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46,20,,,percent of total billed charges,20% of total billed charges,46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,149.5,65,,,percent of total billed charges,65% of total billed charges,149.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46,178,
RP INTER 2.5 FACE,3231025,CDM,450,RC,12051,HCPCS,outpatient,,,291,145.5,,189.15,65,,,percent of total billed charges,65% of total billed charges,197.88,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,20,,,percent of total billed charges,20% of total billed charges,58.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.2,20,,,percent of total billed charges,20% of total billed charges,58.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.15,65,,,percent of total billed charges,65% of total billed charges,189.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,197.88,
RP INTER 2.5CM NECK,3231013,CDM,450,RC,12041,HCPCS,outpatient,,,270.6,135.3,,175.89,65,,,percent of total billed charges,65% of total billed charges,184.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.12,20,,,percent of total billed charges,20% of total billed charges,54.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.12,20,,,percent of total billed charges,20% of total billed charges,54.12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,175.89,65,,,percent of total billed charges,65% of total billed charges,175.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,162.36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,184.01,
RP INTER 2.6-7.5 N-HF/GENT,3231015,CDM,450,RC,12042,HCPCS,outpatient,,,352,176,,228.8,65,,,percent of total billed charges,65% of total billed charges,239.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.4,20,,,percent of total billed charges,20% of total billed charges,70.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.4,20,,,percent of total billed charges,20% of total billed charges,70.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,228.8,65,,,percent of total billed charges,65% of total billed charges,228.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,211.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,239.36,
RP INTER 7.6-12.5 NK,3231017,CDM,450,RC,12044,HCPCS,outpatient,,,445,222.5,,289.25,65,,,percent of total billed charges,65% of total billed charges,302.6,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89,20,,,percent of total billed charges,20% of total billed charges,89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89,20,,,percent of total billed charges,20% of total billed charges,89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,289.25,65,,,percent of total billed charges,65% of total billed charges,289.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,267,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,419,
RP INTERM UP TO 30CM,3231157,CDM,450,RC,,,outpatient,,,542,271,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108.4,20,,,percent of total billed charges,20% of total billed charges,108.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108.4,20,,,percent of total billed charges,20% of total billed charges,108.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,352.3,65,,,percent of total billed charges,65% of total billed charges,352.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.7,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,325.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,352.3,
RP SIMP =/<2CM HEAD/FACE,3230000,CDM,450,RC,12002,HCPCS,outpatient,,,155,77.5,,100.75,65,,,percent of total billed charges,65% of total billed charges,105.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31,20,,,percent of total billed charges,20% of total billed charges,31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31,20,,,percent of total billed charges,20% of total billed charges,31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.75,65,,,percent of total billed charges,65% of total billed charges,100.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31,178,
RP SIMP 2.6-5.0 FACE,3231007,CDM,450,RC,12011,HCPCS,outpatient,,,290.4,145.2,,188.76,65,,,percent of total billed charges,65% of total billed charges,197.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.08,20,,,percent of total billed charges,20% of total billed charges,58.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.08,20,,,percent of total billed charges,20% of total billed charges,58.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,188.76,65,,,percent of total billed charges,65% of total billed charges,188.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,174.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,197.47,
RP SIMP 5.1-7.5 HEAD/FACE,3231009,CDM,450,RC,12014,HCPCS,outpatient,,,334.5,167.25,,217.43,65,,,percent of total billed charges,65% of total billed charges,227.46,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.9,20,,,percent of total billed charges,20% of total billed charges,66.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.9,20,,,percent of total billed charges,20% of total billed charges,66.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,217.43,65,,,percent of total billed charges,65% of total billed charges,217.43,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,200.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,227.46,
RP SIMP 7.6-12.5HEAD/FACE,3231011,CDM,450,RC,12015,HCPCS,outpatient,,,413,206.5,,268.45,65,,,percent of total billed charges,65% of total billed charges,280.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.6,20,,,percent of total billed charges,20% of total billed charges,82.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.6,20,,,percent of total billed charges,20% of total billed charges,82.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,268.45,65,,,percent of total billed charges,65% of total billed charges,268.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,280.84,
RP SIMPLE >30CM,3231155,CDM,450,RC,,,outpatient,,,404,202,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.8,20,,,percent of total billed charges,20% of total billed charges,80.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80.8,20,,,percent of total billed charges,20% of total billed charges,80.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.6,65,,,percent of total billed charges,65% of total billed charges,262.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.4,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,242.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,262.6,
RP SIMPLE 12.6-20CM,3231153,CDM,450,RC,12005,HCPCS,outpatient,,,217,108.5,,141.05,65,,,percent of total billed charges,65% of total billed charges,147.56,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.4,20,,,percent of total billed charges,20% of total billed charges,43.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.4,20,,,percent of total billed charges,20% of total billed charges,43.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.05,65,,,percent of total billed charges,65% of total billed charges,141.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,130.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.4,419,
RP SIMPLE 2.5 FACE,3231151,CDM,450,RC,12011,HCPCS,outpatient,,,213,106.5,,138.45,65,,,percent of total billed charges,65% of total billed charges,144.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,20,,,percent of total billed charges,20% of total billed charges,42.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,20,,,percent of total billed charges,20% of total billed charges,42.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.45,65,,,percent of total billed charges,65% of total billed charges,138.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,178,
RP SIMPLE 2.6-7.5CM GEN/TRUNK/EXTRM,3231003,CDM,450,RC,12002,HCPCS,outpatient,,,226.6,113.3,,147.29,65,,,percent of total billed charges,65% of total billed charges,154.09,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.32,20,,,percent of total billed charges,20% of total billed charges,45.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.32,20,,,percent of total billed charges,20% of total billed charges,45.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147.29,65,,,percent of total billed charges,65% of total billed charges,147.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.32,178,
RP SIMPLE 7.6-12.5CM,3231005,CDM,450,RC,12004,HCPCS,outpatient,,,289.3,144.65,,188.05,65,,,percent of total billed charges,65% of total billed charges,196.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.86,20,,,percent of total billed charges,20% of total billed charges,57.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.86,20,,,percent of total billed charges,20% of total billed charges,57.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,188.05,65,,,percent of total billed charges,65% of total billed charges,188.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,173.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,196.72,
RP SIMPLE TO 2.5CM,3231001,CDM,450,RC,12001,HCPCS,outpatient,,,214.5,107.25,,139.43,65,,,percent of total billed charges,65% of total billed charges,145.86,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,20,,,percent of total billed charges,20% of total billed charges,42.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.9,20,,,percent of total billed charges,20% of total billed charges,42.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,139.43,65,,,percent of total billed charges,65% of total billed charges,139.43,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.9,178,
RPR 1ST INCIS/VNT HERNIA INCARCERATED,3462016,CDM,982,RC,49561,HCPCS,outpatient,,,1328,664,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,665.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,718.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,665.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,665.71,718.31,
RPR 1ST INGUN HRNA 5YRS /> REDUCIBLE,3462032,CDM,982,RC,49505,HCPCS,outpatient,,,739,369.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,375.43,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,605.79,110,,,fee schedule,110% of Medicare physician fee schedule,605.79,110,,,fee schedule,110% of Medicare physician fee schedule,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,633.33,115,,,fee schedule,115% of Medicare physician fee schedule,428.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,375.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,696.66,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,375.43,696.66,
RPR 1ST INGUN HRNA 5YRS/> INCARCERATED,3462027,CDM,982,RC,49507,HCPCS,outpatient,,,833,416.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,421.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,681.79,110,,,fee schedule,110% of Medicare physician fee schedule,681.79,110,,,fee schedule,110% of Medicare physician fee schedule,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,712.78,115,,,fee schedule,115% of Medicare physician fee schedule,473.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,421.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,784.06,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,421.27,784.06,
RPR RECRT INCIS/VNT HERNIA INCARCERATED,3462039,CDM,982,RC,49566,HCPCS,outpatient,,,1340,670,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,671.47,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,724.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,671.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,671.47,724.07,
RPR RECRT INCIS/VNT HERNIA REDUCIBLE,3462038,CDM,982,RC,49565,HCPCS,outpatient,,,1095,547.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,550.76,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,603.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,550.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,550.76,603.36,
RPR RECRT INGUN HERNIA ANY AGE INCARERAT,3462029,CDM,982,RC,49521,HCPCS,outpatient,,,1022,511,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,514.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,832.73,110,,,fee schedule,110% of Medicare physician fee schedule,832.73,110,,,fee schedule,110% of Medicare physician fee schedule,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,870.58,115,,,fee schedule,115% of Medicare physician fee schedule,566.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,514.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,957.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,514.28,957.64,
RPR RECRT INGUN HERNIA ANY AGE REDUCIBLE,3462028,CDM,982,RC,49520,HCPCS,outpatient,,,899,449.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,454.49,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,734.94,110,,,fee schedule,110% of Medicare physician fee schedule,734.94,110,,,fee schedule,110% of Medicare physician fee schedule,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,768.35,115,,,fee schedule,115% of Medicare physician fee schedule,507.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,454.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,845.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,454.49,845.18,
RPR UMBILICAL HERNIA 5YS />INCARCERATED,3462021,CDM,982,RC,49587,HCPCS,outpatient,,,674,337,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,342.93,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,395.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,342.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,342.93,395.53,
RPR UMBILICAL HRNA 5YRS/> REDUCIBLE,3462020,CDM,982,RC,49585,HCPCS,outpatient,,,630,315,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,321.33,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not reimbursable per contract,373.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,321.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,,100,,,other,Not seperately reimbursable,321.33,373.93,
RPR/VDRL,3300491,CDM,302,RC,86592,HCPCS,outpatient,,,35,17.5,,22.75,65,,,percent of total billed charges,65% of total billed charges,23.8,68,,,percent of total billed charges,68% of total billed charges,6.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.75,65,,,percent of total billed charges,65% of total billed charges,22.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,23.8,
RSV,3300923,CDM,306,RC,87807,HCPCS,outpatient,,,52,26,,33.8,65,,,percent of total billed charges,65% of total billed charges,35.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.4,35.36,
RSV BY DFA,3300629,CDM,302,RC,86317,HCPCS,outpatient,,,85,42.5,,55.25,65,,,percent of total billed charges,65% of total billed charges,57.8,68,,,percent of total billed charges,68% of total billed charges,21.28,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.25,65,,,percent of total billed charges,65% of total billed charges,55.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17,57.8,
RSV BY EIA,3300749,CDM,306,RC,87420,HCPCS,outpatient,,,102,51,,66.3,65,,,percent of total billed charges,65% of total billed charges,69.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,20,,,percent of total billed charges,20% of total billed charges,20.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,20,,,percent of total billed charges,20% of total billed charges,20.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.3,65,,,percent of total billed charges,65% of total billed charges,66.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,69.36,
RSV TITER,3300515,CDM,302,RC,86756,HCPCS,outpatient,,,113,56.5,,73.45,65,,,percent of total billed charges,65% of total billed charges,76.84,68,,,percent of total billed charges,68% of total billed charges,18.29,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.6,20,,,percent of total billed charges,20% of total billed charges,22.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.6,20,,,percent of total billed charges,20% of total billed charges,22.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.45,65,,,percent of total billed charges,65% of total billed charges,73.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.29,76.84,
RSVAG BY IF,3300891,CDM,306,RC,87280,HCPCS,outpatient,,,15,7.5,,9.75,65,,,percent of total billed charges,65% of total billed charges,10.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,10.2,
RT SOD CHLORIDE 3% NEB,3500824,CDM,250,RC,J3490,HCPCS,outpatient,,,24,12,,15.6,65,,,percent of total billed charges,65% of total billed charges,16.32,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.8,20,,,percent of total billed charges,20% of total billed charges,4.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.8,20,,,percent of total billed charges,20% of total billed charges,4.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.6,65,,,percent of total billed charges,65% of total billed charges,15.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.8,53.67,
RT- ALBUTEROL NEB [1.25,3500953,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
RT- ALBUTEROL NEB [2.5 MG,3500732,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
RT- ALBUTEROL/ IPRATROPIU,3500733,CDM,250,RC,,,outpatient,,,10.95,5.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.19,20,,,percent of total billed charges,20% of total billed charges,2.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.19,20,,,percent of total billed charges,20% of total billed charges,2.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.12,65,,,percent of total billed charges,65% of total billed charges,7.12,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.19,53.67,
RT- ALBUTEROL/ IPRATROPIU,3500733,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
RT- BUDESONIDE NEB [0.5 M,3500735,CDM,250,RC,,,outpatient,,,61.55,30.78,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.31,20,,,percent of total billed charges,20% of total billed charges,12.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.31,20,,,percent of total billed charges,20% of total billed charges,12.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.01,65,,,percent of total billed charges,65% of total billed charges,40.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.31,53.67,
RT- IPRATROPIUM NEB 0.02%,3500738,CDM,250,RC,,,outpatient,,,6.6,3.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.32,20,,,percent of total billed charges,20% of total billed charges,1.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.32,20,,,percent of total billed charges,20% of total billed charges,1.32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.29,65,,,percent of total billed charges,65% of total billed charges,4.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.32,53.67,
RT- LEVALBUTEROL NEB [1.2,3500739,CDM,250,RC,,,outpatient,,,33.5,16.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.7,20,,,percent of total billed charges,20% of total billed charges,6.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.7,20,,,percent of total billed charges,20% of total billed charges,6.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.78,65,,,percent of total billed charges,65% of total billed charges,21.78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.7,53.67,
RT- RACEPINEPHRINE NEB 2.,3500741,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
RT- SOD CHLORIDE 0.9% NEB,3500742,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
RT-ACETYLCYSTEINE SOL 20%,3500015,CDM,250,RC,J7608,HCPCS,outpatient,,,74.85,37.43,,48.65,65,,,percent of total billed charges,65% of total billed charges,50.9,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.97,20,,,percent of total billed charges,20% of total billed charges,14.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.97,20,,,percent of total billed charges,20% of total billed charges,14.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.65,65,,,percent of total billed charges,65% of total billed charges,48.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,44.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.97,53.67,
RT-FORMOTEROL NEB(20MCG/2ML),3500737,CDM,250,RC,J7606,HCPCS,outpatient,,,52.1,26.05,,33.87,65,,,percent of total billed charges,65% of total billed charges,35.43,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.42,20,,,percent of total billed charges,20% of total billed charges,10.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.42,20,,,percent of total billed charges,20% of total billed charges,10.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.87,65,,,percent of total billed charges,65% of total billed charges,33.87,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,53.67,
RUBELLA VIRUS IGG,3300539,CDM,302,RC,86762,HCPCS,outpatient,,,56,28,,36.4,65,,,percent of total billed charges,65% of total billed charges,38.08,68,,,percent of total billed charges,68% of total billed charges,20.43,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.2,20,,,percent of total billed charges,20% of total billed charges,11.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.2,20,,,percent of total billed charges,20% of total billed charges,11.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.4,65,,,percent of total billed charges,65% of total billed charges,36.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.2,38.08,
RUBEOLA VIRUS IGG,3300541,CDM,302,RC,86765,HCPCS,outpatient,,,92.4,46.2,,60.06,65,,,percent of total billed charges,65% of total billed charges,62.83,68,,,percent of total billed charges,68% of total billed charges,18.29,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.48,20,,,percent of total billed charges,20% of total billed charges,18.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.48,20,,,percent of total billed charges,20% of total billed charges,18.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.06,65,,,percent of total billed charges,65% of total billed charges,60.06,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.29,62.83,
RUSSELL VIPER,3300669,CDM,305,RC,85613,HCPCS,outpatient,,,340,170,,221,65,,,percent of total billed charges,65% of total billed charges,231.2,68,,,percent of total billed charges,68% of total billed charges,13.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68,20,,,percent of total billed charges,20% of total billed charges,68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68,20,,,percent of total billed charges,20% of total billed charges,68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,221,65,,,percent of total billed charges,65% of total billed charges,221,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,204,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.58,231.2,
S I JOINTS-BIL,3400092,CDM,320,RC,72200,HCPCS,outpatient,,,266,133,,172.9,65,,,percent of total billed charges,65% of total billed charges,180.88,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.2,20,,,percent of total billed charges,20% of total billed charges,53.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.2,20,,,percent of total billed charges,20% of total billed charges,53.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,172.9,65,,,percent of total billed charges,65% of total billed charges,172.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180.88,
S I JOINTS-L,3400037,CDM,320,RC,72200,HCPCS,outpatient,,,154,77,,100.1,65,,,percent of total billed charges,65% of total billed charges,104.72,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.8,20,,,percent of total billed charges,20% of total billed charges,30.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.8,20,,,percent of total billed charges,20% of total billed charges,30.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.1,65,,,percent of total billed charges,65% of total billed charges,100.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
S I JOINTS-R,3400091,CDM,320,RC,72200,HCPCS,outpatient,,,154,77,,100.1,65,,,percent of total billed charges,65% of total billed charges,104.72,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.8,20,,,percent of total billed charges,20% of total billed charges,30.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.8,20,,,percent of total billed charges,20% of total billed charges,30.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.1,65,,,percent of total billed charges,65% of total billed charges,100.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,92.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
S S A,3300581,CDM,302,RC,86235,HCPCS,outpatient,,,112,56,,72.8,65,,,percent of total billed charges,65% of total billed charges,76.16,68,,,percent of total billed charges,68% of total billed charges,25.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.8,65,,,percent of total billed charges,65% of total billed charges,72.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,76.16,
S S B,3300583,CDM,302,RC,86235,HCPCS,outpatient,,,112,56,,72.8,65,,,percent of total billed charges,65% of total billed charges,76.16,68,,,percent of total billed charges,68% of total billed charges,25.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.8,65,,,percent of total billed charges,65% of total billed charges,72.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,76.16,
SALICYLATE,3300067,CDM,301,RC,80329,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,39.56,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,40.8,
SALINE CLEANSER SOL,3500744,CDM,250,RC,J3490,HCPCS,outpatient,,,32.6,16.3,,21.19,65,,,percent of total billed charges,65% of total billed charges,22.17,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.52,20,,,percent of total billed charges,20% of total billed charges,6.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.52,20,,,percent of total billed charges,20% of total billed charges,6.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.19,65,,,percent of total billed charges,65% of total billed charges,21.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.52,53.67,
SBSQ HOSP CARE/DAY 15 MIN,3462094,CDM,982,RC,99231,HCPCS,outpatient,,,53,26.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.68,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.14,109,,,fee schedule,109% of Medicare physician fee schedule,110.79,109,,,fee schedule,109% of Medicare physician fee schedule,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.18,115,,,fee schedule,115% of Medicare physician fee schedule,79.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,26.68,100,,,fee schedule,100% of FL Medicaid fee schedule ,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,26.68,110.79,
SBSQ HOSP CARE/DAY 35 MIN,3462096,CDM,982,RC,99233,HCPCS,outpatient,,,140,70,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,71.03,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,130.93,109,,,fee schedule,109% of Medicare physician fee schedule,263.06,109,,,fee schedule,109% of Medicare physician fee schedule,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.14,115,,,fee schedule,115% of Medicare physician fee schedule,123.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.03,263.06,
SBSQ NURS FACIL CARE/DAY E/M STBLE 10 MN,3462105,CDM,982,RC,99307,HCPCS,outpatient,,,60,30,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.24,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.92,109,,,fee schedule,109% of Medicare physician fee schedule,86.24,109,,,fee schedule,109% of Medicare physician fee schedule,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,45.29,115,,,fee schedule,115% of Medicare physician fee schedule,82.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.24,86.24,
SBSQ NURS FACIL CARE/DAY MINOR COMP 15MN,3462106,CDM,982,RC,99308,HCPCS,outpatient,,,92,46,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,47.76,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,81.15,109,,,fee schedule,109% of Medicare physician fee schedule,163.05,109,,,fee schedule,109% of Medicare physician fee schedule,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.62,115,,,fee schedule,115% of Medicare physician fee schedule,100.36,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,94.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,47.76,163.05,
SBSQ NURS FACIL CARE/DAY NEW PROB  25MIN,3462107,CDM,982,RC,99309,HCPCS,outpatient,,,122,61,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,62.88,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,115.89,109,,,fee schedule,109% of Medicare physician fee schedule,232.84,109,,,fee schedule,109% of Medicare physician fee schedule,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.27,115,,,fee schedule,115% of Medicare physician fee schedule,115.48,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,62.88,232.84,
SBSQ NURS FACIL CARE/DAY UNSTBL/NEW PROB,3462108,CDM,982,RC,99310,HCPCS,outpatient,,,180,90,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.63,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,167.08,109,,,fee schedule,109% of Medicare physician fee schedule,335.68,109,,,fee schedule,109% of Medicare physician fee schedule,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,176.27,115,,,fee schedule,115% of Medicare physician fee schedule,145.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,92.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,193.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,92.63,335.68,
SCALPEL W/HANDLE,3060189,CDM,272,RC,,,outpatient,,,7.5,3.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.5,20,,,percent of total billed charges,20% of total billed charges,1.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.5,20,,,percent of total billed charges,20% of total billed charges,1.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.88,65,,,percent of total billed charges,65% of total billed charges,4.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.5,53.67,
SCAPULA BIL,3440171,CDM,972,RC,73010,HCPCS,outpatient,,,79,39.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.63,110,,,fee schedule,110% of Medicare physician fee schedule,25.63,110,,,fee schedule,110% of Medicare physician fee schedule,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,203.2,115,,,fee schedule,115% of Medicare physician fee schedule,69.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.49,203.2,
SCAPULA L,3440173,CDM,972,RC,73010,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.63,110,,,fee schedule,110% of Medicare physician fee schedule,25.63,110,,,fee schedule,110% of Medicare physician fee schedule,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,203.2,115,,,fee schedule,115% of Medicare physician fee schedule,69.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.49,203.2,
SCAPULA RT,3440175,CDM,972,RC,73010,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.63,110,,,fee schedule,110% of Medicare physician fee schedule,25.63,110,,,fee schedule,110% of Medicare physician fee schedule,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,203.2,115,,,fee schedule,115% of Medicare physician fee schedule,69.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.49,203.2,
SCAPULA-BIL,3400094,CDM,320,RC,73010,HCPCS,outpatient,,,212,106,,137.8,65,,,percent of total billed charges,65% of total billed charges,144.16,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.4,20,,,percent of total billed charges,20% of total billed charges,42.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,137.8,65,,,percent of total billed charges,65% of total billed charges,137.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
SCAPULA-LT,3400038,CDM,320,RC,73010,HCPCS,outpatient,,,152,76,,98.8,65,,,percent of total billed charges,65% of total billed charges,103.36,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.4,20,,,percent of total billed charges,20% of total billed charges,30.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.4,20,,,percent of total billed charges,20% of total billed charges,30.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98.8,65,,,percent of total billed charges,65% of total billed charges,98.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
SCAPULA-R,3400093,CDM,320,RC,73010,HCPCS,outpatient,,,167.2,83.6,,108.68,65,,,percent of total billed charges,65% of total billed charges,113.7,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.44,20,,,percent of total billed charges,20% of total billed charges,33.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.44,20,,,percent of total billed charges,20% of total billed charges,33.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108.68,65,,,percent of total billed charges,65% of total billed charges,108.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
SCOPOLAMINE PAT [1.5 MG],3500745,CDM,250,RC,J3490,HCPCS,outpatient,,,5.75,2.88,,3.74,65,,,percent of total billed charges,65% of total billed charges,3.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
SCR/BAR ENE ALT COID,3440177,CDM,972,RC,G0106,HCPCS,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,56.1,110,,,fee schedule,110% of Medicare physician fee schedule,56.1,110,,,fee schedule,110% of Medicare physician fee schedule,,,,,other,Not seperately reimbursable,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,58.65,115,,,fee schedule,115% of Medicare physician fee schedule,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.1,64.52,
SCR/BAR ENE ALT-COLO,3400107,CDM,320,RC,G0106,HCPCS,outpatient,,,361,180.5,,234.65,65,,,percent of total billed charges,65% of total billed charges,245.48,68,,,percent of total billed charges,68% of total billed charges,132.62,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.2,20,,,percent of total billed charges,20% of total billed charges,72.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.2,20,,,percent of total billed charges,20% of total billed charges,72.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,234.65,65,,,percent of total billed charges,65% of total billed charges,234.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,245.48,
SCR/BAR ENE-ALT SIGM,3400106,CDM,320,RC,G0106,HCPCS,outpatient,,,361,180.5,,234.65,65,,,percent of total billed charges,65% of total billed charges,245.48,68,,,percent of total billed charges,68% of total billed charges,132.62,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.2,20,,,percent of total billed charges,20% of total billed charges,72.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.2,20,,,percent of total billed charges,20% of total billed charges,72.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,234.65,65,,,percent of total billed charges,65% of total billed charges,234.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,245.48,
SCR/BAR ENE-ALT SIGM,3440179,CDM,972,RC,G0106,HCPCS,outpatient,,,51,25.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,56.1,110,,,fee schedule,110% of Medicare physician fee schedule,56.1,110,,,fee schedule,110% of Medicare physician fee schedule,,,,,other,Not seperately reimbursable,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,58.65,115,,,fee schedule,115% of Medicare physician fee schedule,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.1,64.52,
SED RATE ESR,3300645,CDM,305,RC,85652,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,3.83,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,30.6,
SELF CARE CURRENT STATUS,3600056,CDM,420,RC,G8987,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
SELF CARE D/C STATUS,3600058,CDM,420,RC,G8989,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
SELF CARE GOAL STATUS,3600057,CDM,420,RC,G8988,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
SEMI-PRIVATE ROOM,3020005,CDM,120,RC,,,inpatient,,,577.5,288.75,,1750,100,,,per diem,"1750 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2600 for 2 days with a per diem after of 1000 or 3600 for 4 days with a per diem after of 1000. It can also pay at a er diem rate of 600, 1500 or 650 if non med/surg procedures are performed",1837,100,,,per diem,"1837 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2730 for 2 days with a per diem after of 1050 or 3780 for 4 days with a per diem after of 1050. It can also pay at a er diem rate of 630, 1575 or 683 if non med/surg procedures are performed",,,,,other,Not separately reimbursable for physician per contract terms,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,115.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,115.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,115.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,115.5,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,MS-DRG,,other,Pays at CMS DRG weights with UHC base rate markup. See MS-DRG rows. Can also pay at per diem rate of 1200 for rehab or SNF,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,115.5,1837,
SEMI-PVT SWINGBED,3020009,CDM,120,RC,,,inpatient,,,504,252,,1750,100,,,per diem,"1750 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2600 for 2 days with a per diem after of 1000 or 3600 for 4 days with a per diem after of 1000. It can also pay at a er diem rate of 600, 1500 or 650 if non med/surg procedures are performed",1837,100,,,per diem,"1837 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2730 for 2 days with a per diem after of 1050 or 3780 for 4 days with a per diem after of 1050. It can also pay at a er diem rate of 630, 1575 or 683 if non med/surg procedures are performed",,,,,other,Not separately reimbursable for physician per contract terms,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,100.8,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,100.8,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,MS-DRG,,other,Pays at CMS DRG weights with UHC base rate markup. See MS-DRG rows. Can also pay at per diem rate of 1200 for rehab or SNF,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,100.8,1837,
SENNA/ DOC SOD TAB,3500746,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
SENNOSIDES TAB [8.6 MG],3500747,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
SENSITIVITY (DISK),3300711,CDM,306,RC,87184,HCPCS,outpatient,,,55,27.5,,35.75,65,,,percent of total billed charges,65% of total billed charges,37.4,68,,,percent of total billed charges,68% of total billed charges,9.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11,20,,,percent of total billed charges,20% of total billed charges,11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.75,65,,,percent of total billed charges,65% of total billed charges,35.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.79,37.4,
"Sensitivity, SO",3300909,CDM,306,RC,87184,HCPCS,outpatient,,,51,25.5,,33.15,65,,,percent of total billed charges,65% of total billed charges,34.68,68,,,percent of total billed charges,68% of total billed charges,9.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.79,34.68,
SEROMA CATH,6215878,CDM,272,RC,,,outpatient,,,422.9,211.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.58,20,,,percent of total billed charges,20% of total billed charges,84.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.58,20,,,percent of total billed charges,20% of total billed charges,84.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,274.89,65,,,percent of total billed charges,65% of total billed charges,274.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,274.89,
SERTRALINE TAB [50 MG],3500749,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
SEVOFLURANE,3521934,CDM,636,RC,J3490,HCPCS,outpatient,,,142.88,71.44,,,,,,other,Not reimbursable per contract ,97.16,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.58,20,,,percent of total billed charges,20% of total billed charges,28.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.58,20,,,percent of total billed charges,20% of total billed charges,28.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.3,80,,,case rate,80% for high cost drug carve out,121.45,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,85.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.58,121.45,
SEX BINDING HORMONE,3300431,CDM,301,RC,84270,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,11.05,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,27.2,
SHOULD BIL MIN:2VIEW,3440185,CDM,972,RC,73030,HCPCS,outpatient,,,89.1,44.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.22,110,,,fee schedule,110% of Medicare physician fee schedule,37.22,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,215.32,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,215.32,
SHOULD L MIN: 2 VIEW,3440189,CDM,972,RC,73030,HCPCS,outpatient,,,50.6,25.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.22,110,,,fee schedule,110% of Medicare physician fee schedule,37.22,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,215.32,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,215.32,
SHOULD R MIN: 2 VIEW,3440193,CDM,972,RC,73030,HCPCS,outpatient,,,50.6,25.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.22,110,,,fee schedule,110% of Medicare physician fee schedule,37.22,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,215.32,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.81,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,215.32,
SHOULD-BIL MIN-2VIEW,3400098,CDM,320,RC,73030,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
SHOULD-L MIN: 2 VIEW,3400040,CDM,320,RC,73030,HCPCS,outpatient,,,137.5,68.75,,89.38,65,,,percent of total billed charges,65% of total billed charges,93.5,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,20,,,percent of total billed charges,20% of total billed charges,27.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,20,,,percent of total billed charges,20% of total billed charges,27.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.38,65,,,percent of total billed charges,65% of total billed charges,89.38,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
SHOULD-R MIN: 2 VIEW,3400097,CDM,320,RC,73030,HCPCS,outpatient,,,137.5,68.75,,89.38,65,,,percent of total billed charges,65% of total billed charges,93.5,68,,,percent of total billed charges,68% of total billed charges,19.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,20,,,percent of total billed charges,20% of total billed charges,27.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.5,20,,,percent of total billed charges,20% of total billed charges,27.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.38,65,,,percent of total billed charges,65% of total billed charges,89.38,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.17,180,
SHOULDER BIL 1 VIEW,3440183,CDM,972,RC,73020,HCPCS,outpatient,,,66,33,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.49,110,,,fee schedule,110% of Medicare physician fee schedule,23.49,110,,,fee schedule,110% of Medicare physician fee schedule,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,200.95,115,,,fee schedule,115% of Medicare physician fee schedule,65.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,12.62,200.95,
SHOULDER L 1 VIEW,3440187,CDM,972,RC,73020,HCPCS,outpatient,,,42.9,21.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.49,110,,,fee schedule,110% of Medicare physician fee schedule,23.49,110,,,fee schedule,110% of Medicare physician fee schedule,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,200.95,115,,,fee schedule,115% of Medicare physician fee schedule,65.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,12.62,200.95,
SHOULDER R 1 VIEW,3440191,CDM,972,RC,73020,HCPCS,outpatient,,,39,19.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,23.49,110,,,fee schedule,110% of Medicare physician fee schedule,23.49,110,,,fee schedule,110% of Medicare physician fee schedule,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,200.95,115,,,fee schedule,115% of Medicare physician fee schedule,65.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,12.62,100,,,fee schedule,100% of FL Medicaid fee schedule ,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,27.01,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,12.62,200.95,
SHOULDER-BIL 1 VIEW,3400096,CDM,320,RC,73020,HCPCS,outpatient,,,141,70.5,,91.65,65,,,percent of total billed charges,65% of total billed charges,95.88,68,,,percent of total billed charges,68% of total billed charges,15.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,20,,,percent of total billed charges,20% of total billed charges,28.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.2,20,,,percent of total billed charges,20% of total billed charges,28.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.65,65,,,percent of total billed charges,65% of total billed charges,91.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,180,
SHOULDER-L 1 VIEW,3400008,CDM,320,RC,73020,HCPCS,outpatient,,,98,49,,63.7,65,,,percent of total billed charges,65% of total billed charges,66.64,68,,,percent of total billed charges,68% of total billed charges,15.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.7,65,,,percent of total billed charges,65% of total billed charges,63.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,180,
SHOULDER-R 1 VIEW,3400095,CDM,320,RC,73020,HCPCS,outpatient,,,98,49,,63.7,65,,,percent of total billed charges,65% of total billed charges,66.64,68,,,percent of total billed charges,68% of total billed charges,15.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.7,65,,,percent of total billed charges,65% of total billed charges,63.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.82,180,
SI JOINT BIL,3440165,CDM,972,RC,72200,HCPCS,outpatient,,,92.4,46.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.44,110,,,fee schedule,110% of Medicare physician fee schedule,35.44,110,,,fee schedule,110% of Medicare physician fee schedule,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.45,115,,,fee schedule,115% of Medicare physician fee schedule,68.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.53,213.45,
SI JOINT L,3440167,CDM,972,RC,72200,HCPCS,outpatient,,,47,23.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.44,110,,,fee schedule,110% of Medicare physician fee schedule,35.44,110,,,fee schedule,110% of Medicare physician fee schedule,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.45,115,,,fee schedule,115% of Medicare physician fee schedule,68.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.53,213.45,
SI JOINT R,3440169,CDM,972,RC,72200,HCPCS,outpatient,,,47,23.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.44,110,,,fee schedule,110% of Medicare physician fee schedule,35.44,110,,,fee schedule,110% of Medicare physician fee schedule,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.45,115,,,fee schedule,115% of Medicare physician fee schedule,68.13,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.53,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,40.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.53,213.45,
SICKLE CELL,3300653,CDM,305,RC,85660,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,7.84,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.84,27.2,
SIGMOID W/BIOPSY,3060225,CDM,750,RC,45331,HCPCS,outpatient,,,1269,634.5,,824.85,65,,,percent of total billed charges,65% of total billed charges,862.92,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,824.85,65,,,percent of total billed charges,65% of total billed charges,824.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,862.92,
SIGMOID W/BLEEDING,3060251,CDM,750,RC,45334,HCPCS,outpatient,,,1269,634.5,,824.85,65,,,percent of total billed charges,65% of total billed charges,862.92,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,824.85,65,,,percent of total billed charges,65% of total billed charges,824.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,862.92,
SIGMOID W/REMOVAL,3060249,CDM,750,RC,45333,HCPCS,outpatient,,,1269,634.5,,824.85,65,,,percent of total billed charges,65% of total billed charges,862.92,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,824.85,65,,,percent of total billed charges,65% of total billed charges,824.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,862.92,
SIGMOID W/RM SNARE,3060247,CDM,750,RC,45338,HCPCS,outpatient,,,1269,634.5,,824.85,65,,,percent of total billed charges,65% of total billed charges,862.92,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,824.85,65,,,percent of total billed charges,65% of total billed charges,824.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,862.92,
SIGMOIDOSCOPE KIT,6215854,CDM,272,RC,,,outpatient,,,152.85,76.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.57,20,,,percent of total billed charges,20% of total billed charges,30.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.57,20,,,percent of total billed charges,20% of total billed charges,30.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.35,65,,,percent of total billed charges,65% of total billed charges,99.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.57,99.35,
SIGMOIDOSCOPY,3060257,CDM,750,RC,G0104,HCPCS,outpatient,,,1269,634.5,,824.85,65,,,percent of total billed charges,65% of total billed charges,862.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.8,20,,,percent of total billed charges,20% of total billed charges,253.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,824.85,65,,,percent of total billed charges,65% of total billed charges,824.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,761.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,862.92,
SILICONE LEVEL,3300361,CDM,301,RC,84285,HCPCS,outpatient,,,106,53,,68.9,65,,,percent of total billed charges,65% of total billed charges,72.08,68,,,percent of total billed charges,68% of total billed charges,33.42,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.2,20,,,percent of total billed charges,20% of total billed charges,21.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.2,20,,,percent of total billed charges,20% of total billed charges,21.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.9,65,,,percent of total billed charges,65% of total billed charges,68.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.2,72.08,
SILVER NITRATE STK,3500750,CDM,250,RC,J3490,HCPCS,outpatient,,,33.3,16.65,,21.65,65,,,percent of total billed charges,65% of total billed charges,22.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.66,20,,,percent of total billed charges,20% of total billed charges,6.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.66,20,,,percent of total billed charges,20% of total billed charges,6.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.65,65,,,percent of total billed charges,65% of total billed charges,21.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,53.67,
SILVER SULFADIAZINE 1% CR,3500751,CDM,250,RC,J3490,HCPCS,outpatient,,,18.15,9.08,,11.8,65,,,percent of total billed charges,65% of total billed charges,12.34,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.63,20,,,percent of total billed charges,20% of total billed charges,3.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.63,20,,,percent of total billed charges,20% of total billed charges,3.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,65,,,percent of total billed charges,65% of total billed charges,11.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.63,53.67,
SILVER SULFADIAZINE 1% CR,3500752,CDM,250,RC,J3490,HCPCS,outpatient,,,129.9,64.95,,84.44,65,,,percent of total billed charges,65% of total billed charges,88.33,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.98,20,,,percent of total billed charges,20% of total billed charges,25.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.98,20,,,percent of total billed charges,20% of total billed charges,25.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.44,65,,,percent of total billed charges,65% of total billed charges,84.44,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,77.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.98,88.33,
SIMETHICONE DRP [40 MG/0.,3500753,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
SIMETHICONE TAB [80 MG],3500754,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
SIMP RPR SCALP/NECK/GENIT/TRNK 2.5CM/<,3462056,CDM,982,RC,12001,HCPCS,outpatient,,,121,60.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.32,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.06,110,,,fee schedule,110% of Medicare physician fee schedule,52.06,110,,,fee schedule,110% of Medicare physician fee schedule,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.43,115,,,fee schedule,115% of Medicare physician fee schedule,82.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,30.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,59.87,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,30.32,82.92,
SIMVASTATIN TAB [10 MG],3500755,CDM,250,RC,J3490,HCPCS,outpatient,,,12.65,6.33,,8.22,65,,,percent of total billed charges,65% of total billed charges,8.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.53,20,,,percent of total billed charges,20% of total billed charges,2.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.53,20,,,percent of total billed charges,20% of total billed charges,2.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.22,65,,,percent of total billed charges,65% of total billed charges,8.22,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.53,53.67,
SIMVASTATIN TAB [20 MG],3500756,CDM,250,RC,J3490,HCPCS,outpatient,,,22.05,11.03,,14.33,65,,,percent of total billed charges,65% of total billed charges,14.99,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.41,20,,,percent of total billed charges,20% of total billed charges,4.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.41,20,,,percent of total billed charges,20% of total billed charges,4.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.33,65,,,percent of total billed charges,65% of total billed charges,14.33,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.41,53.67,
SIMVASTATIN TAB [40 MG],3500757,CDM,250,RC,J3490,HCPCS,outpatient,,,22.05,11.03,,14.33,65,,,percent of total billed charges,65% of total billed charges,14.99,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.41,20,,,percent of total billed charges,20% of total billed charges,4.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.41,20,,,percent of total billed charges,20% of total billed charges,4.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.33,65,,,percent of total billed charges,65% of total billed charges,14.33,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.41,53.67,
SINGLE RAST,3300551,CDM,302,RC,86003,HCPCS,outpatient,,,52,26,,33.8,65,,,percent of total billed charges,65% of total billed charges,35.36,68,,,percent of total billed charges,68% of total billed charges,7.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.41,35.36,
SINUS (WATER) ONLY,3440195,CDM,972,RC,70210,HCPCS,outpatient,,,50.6,25.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.75,110,,,fee schedule,110% of Medicare physician fee schedule,34.75,110,,,fee schedule,110% of Medicare physician fee schedule,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.73,115,,,fee schedule,115% of Medicare physician fee schedule,68.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.96,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.31,212.73,
SINUS (WATERS) ONLY,3400109,CDM,320,RC,70210,HCPCS,outpatient,,,207,103.5,,134.55,65,,,percent of total billed charges,65% of total billed charges,140.76,68,,,percent of total billed charges,68% of total billed charges,20.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,20,,,percent of total billed charges,20% of total billed charges,41.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,20,,,percent of total billed charges,20% of total billed charges,41.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,134.55,65,,,percent of total billed charges,65% of total billed charges,134.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.77,180,
SINUS COM MIN 3 V,3440197,CDM,972,RC,70220,HCPCS,outpatient,,,73.7,36.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,40.46,110,,,fee schedule,110% of Medicare physician fee schedule,40.46,110,,,fee schedule,110% of Medicare physician fee schedule,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,218.7,115,,,fee schedule,115% of Medicare physician fee schedule,73.18,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.58,218.7,
SINUSES COMPL MIN 3V,3400041,CDM,320,RC,70220,HCPCS,outpatient,,,247,123.5,,160.55,65,,,percent of total billed charges,65% of total billed charges,167.96,68,,,percent of total billed charges,68% of total billed charges,26.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.4,20,,,percent of total billed charges,20% of total billed charges,49.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.4,20,,,percent of total billed charges,20% of total billed charges,49.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.55,65,,,percent of total billed charges,65% of total billed charges,160.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.36,180,
SITAGLIPTIN TAB [100 MG],3500759,CDM,250,RC,J3490,HCPCS,outpatient,,,94.7,47.35,,61.56,65,,,percent of total billed charges,65% of total billed charges,64.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.94,20,,,percent of total billed charges,20% of total billed charges,18.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.94,20,,,percent of total billed charges,20% of total billed charges,18.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.56,65,,,percent of total billed charges,65% of total billed charges,61.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.94,64.4,
SITAGLIPTIN TAB [25 MG],3501069,CDM,250,RC,J3490,HCPCS,outpatient,,,94.7,47.35,,61.56,65,,,percent of total billed charges,65% of total billed charges,64.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.94,20,,,percent of total billed charges,20% of total billed charges,18.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.94,20,,,percent of total billed charges,20% of total billed charges,18.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.56,65,,,percent of total billed charges,65% of total billed charges,61.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.94,64.4,
SITAGLIPTIN TAB [50 MG],3500760,CDM,250,RC,J3490,HCPCS,outpatient,,,94.7,47.35,,61.56,65,,,percent of total billed charges,65% of total billed charges,64.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.94,20,,,percent of total billed charges,20% of total billed charges,18.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.94,20,,,percent of total billed charges,20% of total billed charges,18.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.56,65,,,percent of total billed charges,65% of total billed charges,61.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.94,64.4,
SKIN CLEANSER/EMOLLIENT,3500761,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
SKIN STAPLE EXTRACTO,3250513,CDM,272,RC,,,outpatient,,,48.85,24.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.77,20,,,percent of total billed charges,20% of total billed charges,9.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.77,20,,,percent of total billed charges,20% of total billed charges,9.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.75,65,,,percent of total billed charges,65% of total billed charges,31.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,29.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.77,53.67,
SKIN STAPLER DISPOSO,3250509,CDM,272,RC,,,outpatient,,,66.2,33.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.24,20,,,percent of total billed charges,20% of total billed charges,13.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.24,20,,,percent of total billed charges,20% of total billed charges,13.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.03,65,,,percent of total billed charges,65% of total billed charges,43.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.24,53.67,
SKIN STAPLER REGULAR DISP,3250420,CDM,272,RC,,,outpatient,,,40.1,20.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.02,20,,,percent of total billed charges,20% of total billed charges,8.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.02,20,,,percent of total billed charges,20% of total billed charges,8.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.07,65,,,percent of total billed charges,65% of total billed charges,26.07,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.02,53.67,
SKULL < 4 VW,3400042,CDM,320,RC,70250,HCPCS,outpatient,,,208,104,,135.2,65,,,percent of total billed charges,65% of total billed charges,141.44,68,,,percent of total billed charges,68% of total billed charges,20.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.6,20,,,percent of total billed charges,20% of total billed charges,41.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.6,20,,,percent of total billed charges,20% of total billed charges,41.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.2,65,,,percent of total billed charges,65% of total billed charges,135.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,124.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.77,180,
SKULL SERIES 4 VIEW,3440201,CDM,972,RC,70260,HCPCS,outpatient,,,80.3,40.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.04,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.95,110,,,fee schedule,110% of Medicare physician fee schedule,47.95,110,,,fee schedule,110% of Medicare physician fee schedule,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,226.53,115,,,fee schedule,115% of Medicare physician fee schedule,77.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.14,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.04,226.53,
SKULL SERIES 4 VIEWS,3400009,CDM,320,RC,70260,HCPCS,outpatient,,,307,153.5,,199.55,65,,,percent of total billed charges,65% of total billed charges,208.76,68,,,percent of total billed charges,68% of total billed charges,30.04,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.4,20,,,percent of total billed charges,20% of total billed charges,61.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.4,20,,,percent of total billed charges,20% of total billed charges,61.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,199.55,65,,,percent of total billed charges,65% of total billed charges,199.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,184.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.04,208.76,
SKULL<4 V,3440199,CDM,972,RC,70250,HCPCS,outpatient,,,57.2,28.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.79,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,38.62,110,,,fee schedule,110% of Medicare physician fee schedule,38.62,110,,,fee schedule,110% of Medicare physician fee schedule,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,216.78,115,,,fee schedule,115% of Medicare physician fee schedule,72.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.41,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.79,216.78,
SLING ARM CHILD SM,3250067,CDM,271,RC,,,outpatient,,,65.85,32.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.17,20,,,percent of total billed charges,20% of total billed charges,13.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.17,20,,,percent of total billed charges,20% of total billed charges,13.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.8,65,,,percent of total billed charges,65% of total billed charges,42.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,53.67,
SLING ARM LARGE,3250163,CDM,271,RC,,,outpatient,,,21.2,10.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.24,20,,,percent of total billed charges,20% of total billed charges,4.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.24,20,,,percent of total billed charges,20% of total billed charges,4.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.78,65,,,percent of total billed charges,65% of total billed charges,13.78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.24,53.67,
SLING ARM MEDIUM,3250063,CDM,271,RC,,,outpatient,,,33.95,16.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.79,20,,,percent of total billed charges,20% of total billed charges,6.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.79,20,,,percent of total billed charges,20% of total billed charges,6.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.07,65,,,percent of total billed charges,65% of total billed charges,22.07,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.79,53.67,
SLING ARM SMALL,3250203,CDM,271,RC,,,outpatient,,,18.95,9.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.79,20,,,percent of total billed charges,20% of total billed charges,3.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.79,20,,,percent of total billed charges,20% of total billed charges,3.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.32,65,,,percent of total billed charges,65% of total billed charges,12.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.79,53.67,
SNARES,3060053,CDM,272,RC,,,outpatient,,,150,75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,97.5,
SOD BICARB INJ SYR [50 ME,3500764,CDM,636,RC,J3490,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
SOD BICARB TAB [650 MG],3500765,CDM,250,RC,J3490,HCPCS,outpatient,,,3,1.5,,1.95,65,,,percent of total billed charges,65% of total billed charges,2.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
SOD CHLOR 0.65% SPR [44 M,3500766,CDM,250,RC,J3490,HCPCS,outpatient,,,16.2,8.1,,10.53,65,,,percent of total billed charges,65% of total billed charges,11.02,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.24,20,,,percent of total billed charges,20% of total billed charges,3.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.24,20,,,percent of total billed charges,20% of total billed charges,3.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.53,65,,,percent of total billed charges,65% of total billed charges,10.53,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.24,53.67,
SOD CHLOR 0.9% INJ [10 ML,3500767,CDM,250,RC,J3490,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
SOD CHLOR 15000ML,3521889,CDM,258,RC,,,outpatient,,,12.5,6.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,20,,,percent of total billed charges,20% of total billed charges,2.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,20,,,percent of total billed charges,20% of total billed charges,2.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.13,65,,,percent of total billed charges,65% of total billed charges,8.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.5,53.67,
SOD CHLOR 5%  DRP [[15 ML,3500769,CDM,250,RC,J3490,HCPCS,outpatient,,,6.4,3.2,,4.16,65,,,percent of total billed charges,65% of total billed charges,4.35,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.28,20,,,percent of total billed charges,20% of total billed charges,1.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.28,20,,,percent of total billed charges,20% of total billed charges,1.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.16,65,,,percent of total billed charges,65% of total billed charges,4.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.28,53.67,
SOD PHOS MB/ SOD PHOS ENE,3500770,CDM,250,RC,J3490,HCPCS,outpatient,,,10.1,5.05,,6.57,65,,,percent of total billed charges,65% of total billed charges,6.87,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.02,20,,,percent of total billed charges,20% of total billed charges,2.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.02,20,,,percent of total billed charges,20% of total billed charges,2.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,65,,,percent of total billed charges,65% of total billed charges,6.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.02,53.67,
SOD POLY SULF SUSP [15 GM,3500771,CDM,250,RC,J3490,HCPCS,outpatient,,,109.65,54.83,,71.27,65,,,percent of total billed charges,65% of total billed charges,74.56,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.93,20,,,percent of total billed charges,20% of total billed charges,21.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.93,20,,,percent of total billed charges,20% of total billed charges,21.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.27,65,,,percent of total billed charges,65% of total billed charges,71.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.93,74.56,
SODIUM,3300071,CDM,301,RC,84295,HCPCS,outpatient,,,21,10.5,,13.65,65,,,percent of total billed charges,65% of total billed charges,14.28,68,,,percent of total billed charges,68% of total billed charges,6.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,20,,,percent of total billed charges,20% of total billed charges,4.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.65,65,,,percent of total billed charges,65% of total billed charges,13.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,14.28,
SODIUM CHLORIDE 20 ML SDV,3521897,CDM,250,RC,,,outpatient,,,13.15,6.58,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.63,20,,,percent of total billed charges,20% of total billed charges,2.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.63,20,,,percent of total billed charges,20% of total billed charges,2.63,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.55,65,,,percent of total billed charges,65% of total billed charges,8.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.89,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.63,53.67,
SODIUM CHLORIDE OPTHALMIC OINTMENT 5%,3501118,CDM,250,RC,,,outpatient,,,30.1,15.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.02,20,,,percent of total billed charges,20% of total billed charges,6.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.02,20,,,percent of total billed charges,20% of total billed charges,6.02,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.57,65,,,percent of total billed charges,65% of total billed charges,19.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.06,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.02,53.67,
SODIUM CHLORIDE TAB (1GM),3501098,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
SODIUM CLORIDE 2 ML SDV,3511583,CDM,250,RC,,,outpatient,,,9.4,4.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.88,20,,,percent of total billed charges,20% of total billed charges,1.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.88,20,,,percent of total billed charges,20% of total billed charges,1.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.11,65,,,percent of total billed charges,65% of total billed charges,6.11,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.88,53.67,
SODIUM HYPOCHLORITE 0.25%,3500772,CDM,250,RC,J3490,HCPCS,outpatient,,,27.75,13.88,,18.04,65,,,percent of total billed charges,65% of total billed charges,18.87,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.55,20,,,percent of total billed charges,20% of total billed charges,5.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.55,20,,,percent of total billed charges,20% of total billed charges,5.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.04,65,,,percent of total billed charges,65% of total billed charges,18.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.55,53.67,
SODIUM HYPOCHLORITE 0.5%,3500773,CDM,250,RC,J3490,HCPCS,outpatient,,,25.5,12.75,,16.58,65,,,percent of total billed charges,65% of total billed charges,17.34,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.1,20,,,percent of total billed charges,20% of total billed charges,5.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.1,20,,,percent of total billed charges,20% of total billed charges,5.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.58,65,,,percent of total billed charges,65% of total billed charges,16.58,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.1,53.67,
SOFT TISSUE NECK,3400062,CDM,320,RC,70360,HCPCS,outpatient,,,180,90,,117,65,,,percent of total billed charges,65% of total billed charges,122.4,68,,,percent of total billed charges,68% of total billed charges,14.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,20,,,percent of total billed charges,20% of total billed charges,36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,20,,,percent of total billed charges,20% of total billed charges,36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,65,,,percent of total billed charges,65% of total billed charges,117,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,180,
SOFT TISSUE NECK,3440203,CDM,972,RC,70360,HCPCS,outpatient,,,49.5,24.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.07,110,,,fee schedule,110% of Medicare physician fee schedule,34.07,110,,,fee schedule,110% of Medicare physician fee schedule,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,212.02,115,,,fee schedule,115% of Medicare physician fee schedule,67.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.18,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.33,212.02,
SOLU-MEDROL INJ (125 MG),3500552,CDM,636,RC,J2930,HCPCS,outpatient,,,52.35,26.18,,,,,,other,Not reimbursable per contract ,35.6,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.47,20,,,percent of total billed charges,20% of total billed charges,10.47,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.47,20,,,percent of total billed charges,20% of total billed charges,10.47,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.88,80,,,case rate,80% for high cost drug carve out,44.5,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.47,44.5,
SOLU-MEDROL INJ [1 GM],3501071,CDM,250,RC,J2930,HCPCS,outpatient,,,226.25,113.13,,147.06,65,,,percent of total billed charges,65% of total billed charges,153.85,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.25,20,,,percent of total billed charges,20% of total billed charges,45.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.25,20,,,percent of total billed charges,20% of total billed charges,45.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147.06,65,,,percent of total billed charges,65% of total billed charges,147.06,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,135.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.25,153.85,
SOTALOL TAB [80 MG],3500993,CDM,250,RC,J3490,HCPCS,outpatient,,,12.85,6.43,,8.35,65,,,percent of total billed charges,65% of total billed charges,8.74,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.57,20,,,percent of total billed charges,20% of total billed charges,2.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.57,20,,,percent of total billed charges,20% of total billed charges,2.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.35,65,,,percent of total billed charges,65% of total billed charges,8.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.57,53.67,
SPECIAL STAINS GROII,3300827,CDM,310,RC,88313,HCPCS,outpatient,,,61,30.5,,39.65,65,,,percent of total billed charges,65% of total billed charges,41.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.2,20,,,percent of total billed charges,20% of total billed charges,12.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.2,20,,,percent of total billed charges,20% of total billed charges,12.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.65,65,,,percent of total billed charges,65% of total billed charges,39.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.2,41.48,
SPECIFIC GRAVITY FLD,3300449,CDM,301,RC,84315,HCPCS,outpatient,,,5.54,2.77,,3.6,65,,,percent of total billed charges,65% of total billed charges,3.77,68,,,percent of total billed charges,68% of total billed charges,3.56,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.11,20,,,percent of total billed charges,20% of total billed charges,1.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.11,20,,,percent of total billed charges,20% of total billed charges,1.11,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.6,65,,,percent of total billed charges,65% of total billed charges,3.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.77,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.11,3.77,
SPECIMEN CUP 4OZ,3250423,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
SPEECH/HEARING THERAPY,3600039,CDM,440,RC,92507,HCPCS,outpatient,,,105,52.5,,68.25,65,,,percent of total billed charges,65% of total billed charges,71.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,20,,,percent of total billed charges,20% of total billed charges,21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,20,,,percent of total billed charges,20% of total billed charges,21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.25,65,,,percent of total billed charges,65% of total billed charges,68.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,82,
SPHINCTEROTOMY FOR FISSURE,3462041,CDM,982,RC,46080,HCPCS,outpatient,,,364,182,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,108.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,181.24,110,,,fee schedule,110% of Medicare physician fee schedule,181.24,110,,,fee schedule,110% of Medicare physician fee schedule,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,189.47,115,,,fee schedule,115% of Medicare physician fee schedule,160.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,108.22,208.42,
SPINAL NEEDLE 22X35,6215883,CDM,271,RC,,,outpatient,,,16.1,8.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.22,20,,,percent of total billed charges,20% of total billed charges,3.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.22,20,,,percent of total billed charges,20% of total billed charges,3.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.47,65,,,percent of total billed charges,65% of total billed charges,10.47,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.22,53.67,
SPINAL TRAY/KIT,3220259,CDM,272,RC,,,outpatient,,,84.1,42.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.82,20,,,percent of total billed charges,20% of total billed charges,16.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.82,20,,,percent of total billed charges,20% of total billed charges,16.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.67,65,,,percent of total billed charges,65% of total billed charges,54.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.82,54.67,
SPIRONOLACTONE TAB [25 MG,3500774,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
SPLINT CLAVICLE MED,3250071,CDM,271,RC,,,outpatient,,,58.45,29.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.69,20,,,percent of total billed charges,20% of total billed charges,11.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.69,20,,,percent of total billed charges,20% of total billed charges,11.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.99,65,,,percent of total billed charges,65% of total billed charges,37.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.69,53.67,
SPLINT FINGER ALUM,3250173,CDM,271,RC,,,outpatient,,,15.5,7.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.08,65,,,percent of total billed charges,65% of total billed charges,10.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.1,53.67,
SPLINT VIN F-ARM LLA,3250253,CDM,271,RC,,,outpatient,,,72.55,36.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.51,20,,,percent of total billed charges,20% of total billed charges,14.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.51,20,,,percent of total billed charges,20% of total billed charges,14.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.16,65,,,percent of total billed charges,65% of total billed charges,47.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.51,53.67,
SPLINT VIN F-ARM LME,3250251,CDM,271,RC,,,outpatient,,,65.5,32.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.1,20,,,percent of total billed charges,20% of total billed charges,13.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.1,20,,,percent of total billed charges,20% of total billed charges,13.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.58,65,,,percent of total billed charges,65% of total billed charges,42.58,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.1,53.67,
SPLINT VIN F-ARM LSM,3250249,CDM,271,RC,,,outpatient,,,72.55,36.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.51,20,,,percent of total billed charges,20% of total billed charges,14.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.51,20,,,percent of total billed charges,20% of total billed charges,14.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.16,65,,,percent of total billed charges,65% of total billed charges,47.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.51,53.67,
SPLINT VIN F-ARM RLA,3250247,CDM,271,RC,,,outpatient,,,72.55,36.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.51,20,,,percent of total billed charges,20% of total billed charges,14.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.51,20,,,percent of total billed charges,20% of total billed charges,14.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.16,65,,,percent of total billed charges,65% of total billed charges,47.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.51,53.67,
SPLINT VIN F-ARM RME,3250245,CDM,271,RC,,,outpatient,,,65.5,32.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.1,20,,,percent of total billed charges,20% of total billed charges,13.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.1,20,,,percent of total billed charges,20% of total billed charges,13.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.58,65,,,percent of total billed charges,65% of total billed charges,42.58,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.1,53.67,
SPLINT VIN F-ARM RSM,3250243,CDM,271,RC,,,outpatient,,,72.55,36.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.51,20,,,percent of total billed charges,20% of total billed charges,14.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.51,20,,,percent of total billed charges,20% of total billed charges,14.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.16,65,,,percent of total billed charges,65% of total billed charges,47.16,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.51,53.67,
"SPONGE, LAP 18X18",6210250,CDM,272,RC,,,outpatient,,,19.16,9.58,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.83,20,,,percent of total billed charges,20% of total billed charges,3.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.83,20,,,percent of total billed charges,20% of total billed charges,3.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.45,65,,,percent of total billed charges,65% of total billed charges,12.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.83,53.67,
SPUTUM COLLECTION,3170081,CDM,410,RC,94640,HCPCS,outpatient,,,135.26,67.63,,87.92,65,,,percent of total billed charges,65% of total billed charges,91.98,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.05,20,,,percent of total billed charges,20% of total billed charges,27.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.05,20,,,percent of total billed charges,20% of total billed charges,27.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.92,65,,,percent of total billed charges,65% of total billed charges,87.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,81.16,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.05,91.98,
ST-ATTEN CURRENT STATUS,3600065,CDM,440,RC,G9165,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-ATTEN D/C STATUS,3600067,CDM,440,RC,G9167,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-ATTEN GOAL STATUS,3600066,CDM,440,RC,G9166,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-LANG COMP CURRENT STATUS,3600068,CDM,440,RC,G9159,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-LANG COMP D/C STATUS,3600070,CDM,440,RC,G9161,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-LANG COMP GOAL STATUS,3600069,CDM,440,RC,G9160,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-LANG D/C STATUS,3600082,CDM,440,RC,G9176,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-LANG EXPRESS CURRENT STATUS,3600071,CDM,440,RC,G9162,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-LANG EXPRESS D/C STATUS,3600073,CDM,440,RC,G9164,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-LANG EXPRESS GOAL STATUS,3600072,CDM,440,RC,G9163,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-MEMORY CURRENT STATUS,3600074,CDM,440,RC,G9168,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-MEMORY D/C STATUS,3600076,CDM,440,RC,G9170,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-MEMORY GOAL STATUS,3600075,CDM,440,RC,G9169,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-MOTOR SPEECH CURRENT STATUS,3600077,CDM,440,RC,G8999,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-MOTOR SPEECH D/C STATUS,3600079,CDM,440,RC,G9158,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-MOTOR SPEECH GOAL STATUS,3600078,CDM,440,RC,G9186,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-SPEECH LANG CURRENT STATUS,3600080,CDM,440,RC,G9174,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-SPEECH LANG GOAL STATUS,3600081,CDM,440,RC,G9175,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-SWALLOW CURRENT STATUS,3600083,CDM,440,RC,G8996,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-SWALLOW D/C STATUS,3600085,CDM,440,RC,G8998,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-SWALLOW GOAL STATUS,3600084,CDM,440,RC,G8997,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-VOICE CURRENT STATUS,3600086,CDM,440,RC,G9171,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-VOICE D/C STATUS,3600088,CDM,440,RC,G9173,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
ST-VOICE GOAL STATUS,3600087,CDM,440,RC,G9172,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
STAPLER LINEAR REFILL 30 MM,6215821,CDM,272,RC,,,outpatient,,,345.04,172.52,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.01,20,,,percent of total billed charges,20% of total billed charges,69.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.01,20,,,percent of total billed charges,20% of total billed charges,69.01,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,224.28,65,,,percent of total billed charges,65% of total billed charges,224.28,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.02,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,224.28,
STAPLER LINEAR REFILL 60 MM,6215822,CDM,272,RC,,,outpatient,,,371.64,185.82,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.33,20,,,percent of total billed charges,20% of total billed charges,74.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.33,20,,,percent of total billed charges,20% of total billed charges,74.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,241.57,65,,,percent of total billed charges,65% of total billed charges,241.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,222.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,241.57,
STAPLER VASC REFILL 30 MM,6215823,CDM,272,RC,,,outpatient,,,354.73,177.37,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.95,20,,,percent of total billed charges,20% of total billed charges,70.95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.95,20,,,percent of total billed charges,20% of total billed charges,70.95,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,230.57,65,,,percent of total billed charges,65% of total billed charges,230.57,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,212.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,230.57,
STAPLER W/COUNTER,6210249,CDM,272,RC,,,outpatient,,,63.38,31.69,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.68,20,,,percent of total billed charges,20% of total billed charges,12.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.68,20,,,percent of total billed charges,20% of total billed charges,12.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.2,65,,,percent of total billed charges,65% of total billed charges,41.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.03,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.68,53.67,
"STAPLER, LINEAR 30",6215775,CDM,272,RC,,,outpatient,,,795.41,397.71,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.08,20,,,percent of total billed charges,20% of total billed charges,159.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.08,20,,,percent of total billed charges,20% of total billed charges,159.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,517.02,65,,,percent of total billed charges,65% of total billed charges,517.02,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,477.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,517.02,
"STAPLER, LINEAR 30-2.5",6215776,CDM,272,RC,,,outpatient,,,872.89,436.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.58,20,,,percent of total billed charges,20% of total billed charges,174.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,174.58,20,,,percent of total billed charges,20% of total billed charges,174.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,567.38,65,,,percent of total billed charges,65% of total billed charges,567.38,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,523.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,567.38,
"STAPLER, LINEAR 60",6215774,CDM,272,RC,,,outpatient,,,822.6,411.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,164.52,20,,,percent of total billed charges,20% of total billed charges,164.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,164.52,20,,,percent of total billed charges,20% of total billed charges,164.52,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,534.69,65,,,percent of total billed charges,65% of total billed charges,534.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,493.56,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,534.69,
STATLOCK PICC DENCE,3250614,CDM,272,RC,,,outpatient,,,91.8,45.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.36,20,,,percent of total billed charges,20% of total billed charges,18.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.36,20,,,percent of total billed charges,20% of total billed charges,18.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.67,65,,,percent of total billed charges,65% of total billed charges,59.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,55.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.36,59.67,
STERILE FIELD 16X29,3250383,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
STERILE WATER INJ (50ML),3501094,CDM,250,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
STERISTRIP 1/2X4,3250313,CDM,272,RC,,,outpatient,,,12.2,6.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.44,20,,,percent of total billed charges,20% of total billed charges,2.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.44,20,,,percent of total billed charges,20% of total billed charges,2.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.93,65,,,percent of total billed charges,65% of total billed charges,7.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.44,53.67,
STERISTRIP 1/4X4IN,3250395,CDM,272,RC,,,outpatient,,,7.85,3.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.57,20,,,percent of total billed charges,20% of total billed charges,1.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.57,20,,,percent of total billed charges,20% of total billed charges,1.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.1,65,,,percent of total billed charges,65% of total billed charges,5.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.71,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.57,53.67,
STERNUM MIN 2 V,3440205,CDM,972,RC,71120,HCPCS,outpatient,,,50.6,25.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.11,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.21,110,,,fee schedule,110% of Medicare physician fee schedule,36.21,110,,,fee schedule,110% of Medicare physician fee schedule,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.26,115,,,fee schedule,115% of Medicare physician fee schedule,68.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,16.11,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,16.11,214.26,
STERNUM MIN 2 VIEW,3400048,CDM,320,RC,71120,HCPCS,outpatient,,,205,102.5,,133.25,65,,,percent of total billed charges,65% of total billed charges,139.4,68,,,percent of total billed charges,68% of total billed charges,21.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41,20,,,percent of total billed charges,20% of total billed charges,41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41,20,,,percent of total billed charges,20% of total billed charges,41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,133.25,65,,,percent of total billed charges,65% of total billed charges,133.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,123,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.73,180,
STETHOSCOPE DISPOSABLE,3250045,CDM,270,RC,,,outpatient,,,61.25,30.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.25,20,,,percent of total billed charges,20% of total billed charges,12.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.25,20,,,percent of total billed charges,20% of total billed charges,12.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.81,65,,,percent of total billed charges,65% of total billed charges,39.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.25,53.67,
STOCKING TED KN LRG,3250125,CDM,272,RC,,,outpatient,,,40.4,20.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.26,65,,,percent of total billed charges,65% of total billed charges,26.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.08,53.67,
STOCKING TED KN MED,3250123,CDM,272,RC,,,outpatient,,,40.4,20.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.26,65,,,percent of total billed charges,65% of total billed charges,26.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.08,53.67,
STOCKING TED KN SM,3250083,CDM,272,RC,,,outpatient,,,40.4,20.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.26,65,,,percent of total billed charges,65% of total billed charges,26.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.08,53.67,
STOCKING TED KN XLG,3250121,CDM,272,RC,,,outpatient,,,40.4,20.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.08,20,,,percent of total billed charges,20% of total billed charges,8.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.26,65,,,percent of total billed charges,65% of total billed charges,26.26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.08,53.67,
STOCKING TED TH LRG,3250129,CDM,272,RC,,,outpatient,,,70.2,35.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.63,65,,,percent of total billed charges,65% of total billed charges,45.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.04,53.67,
STOCKING TED TH MED,3250185,CDM,272,RC,,,outpatient,,,70.2,35.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.63,65,,,percent of total billed charges,65% of total billed charges,45.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.04,53.67,
STOCKING TED TH SM,3250127,CDM,272,RC,,,outpatient,,,70.2,35.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.04,20,,,percent of total billed charges,20% of total billed charges,14.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.63,65,,,percent of total billed charges,65% of total billed charges,45.63,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.04,53.67,
STOCKING TED TH XLG,3250109,CDM,272,RC,,,outpatient,,,84.85,42.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.97,20,,,percent of total billed charges,20% of total billed charges,16.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.97,20,,,percent of total billed charges,20% of total billed charges,16.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.15,65,,,percent of total billed charges,65% of total billed charges,55.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.97,55.15,
STOCKING THIGH 2XL,3250131,CDM,270,RC,,,outpatient,,,83.34,41.67,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.67,20,,,percent of total billed charges,20% of total billed charges,16.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.67,20,,,percent of total billed charges,20% of total billed charges,16.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.17,65,,,percent of total billed charges,65% of total billed charges,54.17,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.67,54.17,
STOCKING THIGH XXL,3250225,CDM,272,RC,,,outpatient,,,75.15,37.58,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.03,20,,,percent of total billed charges,20% of total billed charges,15.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.03,20,,,percent of total billed charges,20% of total billed charges,15.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.85,65,,,percent of total billed charges,65% of total billed charges,48.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.03,53.67,
"STOCKING, THIGH XL",3250130,CDM,270,RC,,,outpatient,,,82.4,41.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.48,20,,,percent of total billed charges,20% of total billed charges,16.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.48,20,,,percent of total billed charges,20% of total billed charges,16.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.56,65,,,percent of total billed charges,65% of total billed charges,53.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.48,53.67,
STOMA DRAIN POUCH 2 3/4in,3250681,CDM,272,RC,,,outpatient,,,34.4,17.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.88,20,,,percent of total billed charges,20% of total billed charges,6.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.88,20,,,percent of total billed charges,20% of total billed charges,6.88,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.36,65,,,percent of total billed charges,65% of total billed charges,22.36,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.64,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.88,53.67,
STOMA FLANGE 2 1/4in,3250683,CDM,272,RC,,,outpatient,,,37.9,18.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.58,20,,,percent of total billed charges,20% of total billed charges,7.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.58,20,,,percent of total billed charges,20% of total billed charges,7.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.64,65,,,percent of total billed charges,65% of total billed charges,24.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.58,53.67,
STOMA POUCH 2 1/4,3250694,CDM,270,RC,,,outpatient,,,14.45,7.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.89,20,,,percent of total billed charges,20% of total billed charges,2.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.89,20,,,percent of total billed charges,20% of total billed charges,2.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.39,65,,,percent of total billed charges,65% of total billed charges,9.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.89,53.67,
STOMA WAFER 2 1/4in,3250682,CDM,272,RC,,,outpatient,,,46.75,23.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.35,20,,,percent of total billed charges,20% of total billed charges,9.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.35,20,,,percent of total billed charges,20% of total billed charges,9.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.39,65,,,percent of total billed charges,65% of total billed charges,30.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.35,53.67,
STONE ANALYSIS,3300015,CDM,301,RC,82360,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,12.09,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.09,61.2,
STOOL MGMT COLLECTION BAG-DIGNISHIELD,3250504,CDM,271,RC,,,outpatient,,,84.65,42.33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.93,20,,,percent of total billed charges,20% of total billed charges,16.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.93,20,,,percent of total billed charges,20% of total billed charges,16.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.02,65,,,percent of total billed charges,65% of total billed charges,55.02,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.93,55.02,
STOOL MGMT SYSTEM DIGNISHIELD,3250502,CDM,272,RC,,,outpatient,,,604.87,302.44,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.97,20,,,percent of total billed charges,20% of total billed charges,120.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.97,20,,,percent of total billed charges,20% of total billed charges,120.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,393.17,65,,,percent of total billed charges,65% of total billed charges,393.17,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,362.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,393.17,
STRAPPING UNNA BOOT,3462067,CDM,982,RC,29580,HCPCS,outpatient,,,210,105,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.89,110,,,fee schedule,110% of Medicare physician fee schedule,29.89,110,,,fee schedule,110% of Medicare physician fee schedule,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.25,115,,,fee schedule,115% of Medicare physician fee schedule,70.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,34.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.95,70.55,
"STYLET, RIGID",4000046,CDM,272,RC,,,outpatient,,,175.75,87.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.15,20,,,percent of total billed charges,20% of total billed charges,35.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.15,20,,,percent of total billed charges,20% of total billed charges,35.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.24,65,,,percent of total billed charges,65% of total billed charges,114.24,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.15,114.24,
SUB PT/OT CURRENT STATUS,3600062,CDM,420,RC,G8993,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
SUB PT/OT D/C STATUS,3600064,CDM,420,RC,G8995,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
SUB PT/OT GOAL STATUS,3600063,CDM,420,RC,G8994,HCPCS,outpatient,,,0.01,0.01,,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not separately reimbursable per contract terms,,,,,other,Not separately reimbursable per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,65,,,percent of total billed charges,65% of total billed charges,0.01,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.01,82,
SUBQ HOSP CARE/DAY 25 MIN,3462095,CDM,982,RC,99232,HCPCS,outpatient,,,97,48.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,49.44,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,87.03,109,,,fee schedule,109% of Medicare physician fee schedule,174.85,109,,,fee schedule,109% of Medicare physician fee schedule,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,91.82,115,,,fee schedule,115% of Medicare physician fee schedule,102.04,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.44,174.85,
SUCCINYLCHOLINE INJ (20 M,3500776,CDM,636,RC,J0330,HCPCS,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,17,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,80,,,case rate,80% for high cost drug carve out,21.25,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,21.25,
SUCRALFATE SUSP [1 GM/10,3500777,CDM,250,RC,J3490,HCPCS,outpatient,,,60.9,30.45,,39.59,65,,,percent of total billed charges,65% of total billed charges,41.41,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.18,20,,,percent of total billed charges,20% of total billed charges,12.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.18,20,,,percent of total billed charges,20% of total billed charges,12.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.59,65,,,percent of total billed charges,65% of total billed charges,39.59,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.18,53.67,
SUCRALFATE TAB [1 GM],3500778,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
SUCTION CATH,3170033,CDM,272,RC,,,outpatient,,,4.15,2.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.83,20,,,percent of total billed charges,20% of total billed charges,0.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.83,20,,,percent of total billed charges,20% of total billed charges,0.83,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.7,65,,,percent of total billed charges,65% of total billed charges,2.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.49,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.83,53.67,
SUCTION MACH BOTL,3170021,CDM,271,RC,,,outpatient,,,51.95,25.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.39,20,,,percent of total billed charges,20% of total billed charges,10.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.39,20,,,percent of total billed charges,20% of total billed charges,10.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.77,65,,,percent of total billed charges,65% of total billed charges,33.77,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.39,53.67,
SUCTION SUPPLIES,3060099,CDM,272,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
SUCTION TIP YANKAUER,3220258,CDM,272,RC,,,outpatient,,,13.7,6.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.74,20,,,percent of total billed charges,20% of total billed charges,2.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.74,20,,,percent of total billed charges,20% of total billed charges,2.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.91,65,,,percent of total billed charges,65% of total billed charges,8.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.74,53.67,
SUCTION TIP YANKER,3060143,CDM,272,RC,,,outpatient,,,13.7,6.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.74,20,,,percent of total billed charges,20% of total billed charges,2.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.74,20,,,percent of total billed charges,20% of total billed charges,2.74,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.91,65,,,percent of total billed charges,65% of total billed charges,8.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.22,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.74,53.67,
SUCTION TUBING,3170110,CDM,272,RC,,,outpatient,,,6.63,3.32,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.33,20,,,percent of total billed charges,20% of total billed charges,1.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.33,20,,,percent of total billed charges,20% of total billed charges,1.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.31,65,,,percent of total billed charges,65% of total billed charges,4.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.33,53.67,
SUCTION TUBING 10FT 1/4,3250378,CDM,271,RC,,,outpatient,,,9.1,4.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.82,20,,,percent of total billed charges,20% of total billed charges,1.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.82,20,,,percent of total billed charges,20% of total billed charges,1.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.92,65,,,percent of total billed charges,65% of total billed charges,5.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.82,53.67,
SULFACETAMIDE SODIUM OPTH SOL [5 %],3501150,CDM,250,RC,,,outpatient,,,305,152.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61,20,,,percent of total billed charges,20% of total billed charges,61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61,20,,,percent of total billed charges,20% of total billed charges,61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,198.25,65,,,percent of total billed charges,65% of total billed charges,198.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,198.25,
SULFAMETH/ TMP DS TAB [80,3500779,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
SULFAMETH/ TMP SUS [200-4,3500296,CDM,250,RC,J3490,HCPCS,outpatient,,,11.4,5.7,,7.41,65,,,percent of total billed charges,65% of total billed charges,7.75,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.28,20,,,percent of total billed charges,20% of total billed charges,2.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.28,20,,,percent of total billed charges,20% of total billed charges,2.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.41,65,,,percent of total billed charges,65% of total billed charges,7.41,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.28,53.67,
SULFAMETH/TMP INJ [80-16M,3501062,CDM,250,RC,J3490,HCPCS,outpatient,,,67.75,33.88,,44.04,65,,,percent of total billed charges,65% of total billed charges,46.07,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.55,20,,,percent of total billed charges,20% of total billed charges,13.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.55,20,,,percent of total billed charges,20% of total billed charges,13.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.04,65,,,percent of total billed charges,65% of total billed charges,44.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.55,53.67,
SULFASALAZINE TAB [500 MG,3500781,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
SUMATRIPTAN INJ [6 MG/0.5,3500782,CDM,636,RC,J3030,HCPCS,outpatient,,,382.5,191.25,,,,,,other,Not reimbursable per contract ,260.1,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.5,20,,,percent of total billed charges,20% of total billed charges,76.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.5,20,,,percent of total billed charges,20% of total billed charges,76.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,306,80,,,case rate,80% for high cost drug carve out,325.13,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,229.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.5,325.13,
"SUP-ACE BANDAGE 4""",3700031,CDM,271,RC,,,outpatient,,,7,3.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.4,20,,,percent of total billed charges,20% of total billed charges,1.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.4,20,,,percent of total billed charges,20% of total billed charges,1.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.55,65,,,percent of total billed charges,65% of total billed charges,4.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.4,53.67,
SUP-GAUZE ST4X4 12PL,3700025,CDM,270,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
SUP-SLING ARM,3700023,CDM,270,RC,,,outpatient,,,31,15.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.15,65,,,percent of total billed charges,65% of total billed charges,20.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.2,53.67,
SUP-SLING ARM LARGE,3700029,CDM,271,RC,,,outpatient,,,31,15.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.15,65,,,percent of total billed charges,65% of total billed charges,20.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.2,53.67,
SUP-SPLINT FINGER,3700027,CDM,270,RC,,,outpatient,,,15,7.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,53.67,
SUP-SPLINT HAND,3700013,CDM,270,RC,,,outpatient,,,59,29.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.35,65,,,percent of total billed charges,65% of total billed charges,38.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.8,53.67,
SUP-SPLINT WR/FRARM,3700007,CDM,270,RC,,,outpatient,,,59,29.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.8,20,,,percent of total billed charges,20% of total billed charges,11.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.35,65,,,percent of total billed charges,65% of total billed charges,38.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.8,53.67,
SUP-SUTURE TRAY,3700041,CDM,272,RC,,,outpatient,,,52,26,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.4,53.67,
SUP-TELFA 3X4 NON ST,3700037,CDM,271,RC,,,outpatient,,,2.75,1.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.55,20,,,percent of total billed charges,20% of total billed charges,0.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.55,20,,,percent of total billed charges,20% of total billed charges,0.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.79,65,,,percent of total billed charges,65% of total billed charges,1.79,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.55,53.67,
SURG TX ANAL FISTULA SUBQ,3462042,CDM,982,RC,46270,HCPCS,outpatient,,,706,353,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,273.6,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,451.32,110,,,fee schedule,110% of Medicare physician fee schedule,451.32,110,,,fee schedule,110% of Medicare physician fee schedule,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,471.83,115,,,fee schedule,115% of Medicare physician fee schedule,326.2,100,,,fee schedule,100% of FL Medicaid fee schedule ,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,273.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,519.02,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,273.6,519.02,
SURGERY 1 HR,3060221,CDM,361,RC,,,outpatient,,,866,433,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,173.2,20,,,percent of total billed charges,20% of total billed charges,173.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,173.2,20,,,percent of total billed charges,20% of total billed charges,173.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,562.9,65,,,percent of total billed charges,65% of total billed charges,562.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,303.1,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,519.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,562.9,
SURGERY 15 MINUTES,3060207,CDM,360,RC,,,outpatient,,,262,131,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.4,20,,,percent of total billed charges,20% of total billed charges,52.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.4,20,,,percent of total billed charges,20% of total billed charges,52.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.3,65,,,percent of total billed charges,65% of total billed charges,170.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.7,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.4,170.3,
SURGERY 30 MINUTES,3060219,CDM,361,RC,,,outpatient,,,433,216.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.6,20,,,percent of total billed charges,20% of total billed charges,86.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.6,20,,,percent of total billed charges,20% of total billed charges,86.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,281.45,65,,,percent of total billed charges,65% of total billed charges,281.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,151.55,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,281.45,
SURGICEL 1/2 X2,3250277,CDM,272,RC,,,outpatient,,,236.5,118.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.3,20,,,percent of total billed charges,20% of total billed charges,47.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.3,20,,,percent of total billed charges,20% of total billed charges,47.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,153.73,65,,,percent of total billed charges,65% of total billed charges,153.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,141.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.3,153.73,
SURGICEL 4X8,3250278,CDM,272,RC,,,outpatient,,,215.95,107.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.19,20,,,percent of total billed charges,20% of total billed charges,43.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.19,20,,,percent of total billed charges,20% of total billed charges,43.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140.37,65,,,percent of total billed charges,65% of total billed charges,140.37,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.19,140.37,
SURGIFOAM 3X4,6215801,CDM,272,RC,,,outpatient,,,204.2,102.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.84,20,,,percent of total billed charges,20% of total billed charges,40.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.84,20,,,percent of total billed charges,20% of total billed charges,40.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.73,65,,,percent of total billed charges,65% of total billed charges,132.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.84,132.73,
SUTURE 1669H,6210259,CDM,272,RC,,,outpatient,,,68.8,34.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.76,20,,,percent of total billed charges,20% of total billed charges,13.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.76,20,,,percent of total billed charges,20% of total billed charges,13.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.72,65,,,percent of total billed charges,65% of total billed charges,44.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.76,53.67,
SUTURE 3/0 H822H FS-2,3250356,CDM,272,RC,,,outpatient,,,137.28,68.64,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.46,20,,,percent of total billed charges,20% of total billed charges,27.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.46,20,,,percent of total billed charges,20% of total billed charges,27.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.23,65,,,percent of total billed charges,65% of total billed charges,89.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,82.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.46,89.23,
SUTURE 3/0 VICRYL PS-2 J497G,3250354,CDM,272,RC,,,outpatient,,,83.35,41.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.67,20,,,percent of total billed charges,20% of total billed charges,16.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.67,20,,,percent of total billed charges,20% of total billed charges,16.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.18,65,,,percent of total billed charges,65% of total billed charges,54.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.67,54.18,
SUTURE 4-0 ETH 699G,3250623,CDM,272,RC,,,outpatient,,,63.8,31.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.76,20,,,percent of total billed charges,20% of total billed charges,12.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.76,20,,,percent of total billed charges,20% of total billed charges,12.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.47,65,,,percent of total billed charges,65% of total billed charges,41.47,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.76,53.67,
SUTURE 662H,6210258,CDM,272,RC,,,outpatient,,,38.28,19.14,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.66,20,,,percent of total billed charges,20% of total billed charges,7.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.66,20,,,percent of total billed charges,20% of total billed charges,7.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.88,65,,,percent of total billed charges,65% of total billed charges,24.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.66,53.67,
SUTURE 664G,6215869,CDM,272,RC,,,outpatient,,,21.95,10.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.39,20,,,percent of total billed charges,20% of total billed charges,4.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.39,20,,,percent of total billed charges,20% of total billed charges,4.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.27,65,,,percent of total billed charges,65% of total billed charges,14.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.39,53.67,
SUTURE 8417H,6215841,CDM,272,RC,,,outpatient,,,34,17,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.1,65,,,percent of total billed charges,65% of total billed charges,22.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.8,53.67,
SUTURE 8833H,6215840,CDM,272,RC,,,outpatient,,,34.65,17.33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.93,20,,,percent of total billed charges,20% of total billed charges,6.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.93,20,,,percent of total billed charges,20% of total billed charges,6.93,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.52,65,,,percent of total billed charges,65% of total billed charges,22.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.79,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.93,53.67,
SUTURE A304H,6210255,CDM,272,RC,,,outpatient,,,60.79,30.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.16,20,,,percent of total billed charges,20% of total billed charges,12.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.16,20,,,percent of total billed charges,20% of total billed charges,12.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.51,65,,,percent of total billed charges,65% of total billed charges,39.51,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.47,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.16,53.67,
SUTURE CHROMIC GUT 4/0 P3,3250665,CDM,272,RC,,,outpatient,,,86.3,43.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.26,20,,,percent of total billed charges,20% of total billed charges,17.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.26,20,,,percent of total billed charges,20% of total billed charges,17.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.1,65,,,percent of total billed charges,65% of total billed charges,56.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.26,56.1,
SUTURE D6929,6215842,CDM,272,RC,,,outpatient,,,168,84,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.2,65,,,percent of total billed charges,65% of total billed charges,109.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.6,109.2,
SUTURE D7414,6215846,CDM,272,RC,,,outpatient,,,171.8,85.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.36,20,,,percent of total billed charges,20% of total billed charges,34.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.36,20,,,percent of total billed charges,20% of total billed charges,34.36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111.67,65,,,percent of total billed charges,65% of total billed charges,111.67,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.08,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.36,111.67,
SUTURE D7463,6215850,CDM,272,RC,,,outpatient,,,204.7,102.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.94,20,,,percent of total billed charges,20% of total billed charges,40.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.94,20,,,percent of total billed charges,20% of total billed charges,40.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,133.06,65,,,percent of total billed charges,65% of total billed charges,133.06,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,122.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.94,133.06,
SUTURE D8551,6215845,CDM,272,RC,,,outpatient,,,250.25,125.13,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.05,20,,,percent of total billed charges,20% of total billed charges,50.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.05,20,,,percent of total billed charges,20% of total billed charges,50.05,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162.66,65,,,percent of total billed charges,65% of total billed charges,162.66,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,150.15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.05,162.66,
SUTURE D8552,6215844,CDM,272,RC,,,outpatient,,,214.55,107.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.91,20,,,percent of total billed charges,20% of total billed charges,42.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.91,20,,,percent of total billed charges,20% of total billed charges,42.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,139.46,65,,,percent of total billed charges,65% of total billed charges,139.46,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,128.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.91,139.46,
SUTURE D9566,6215839,CDM,272,RC,,,outpatient,,,266.35,133.18,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.27,20,,,percent of total billed charges,20% of total billed charges,53.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.27,20,,,percent of total billed charges,20% of total billed charges,53.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,173.13,65,,,percent of total billed charges,65% of total billed charges,173.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.27,173.13,
SUTURE G122H,6210256,CDM,272,RC,,,outpatient,,,59.6,29.8,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.92,20,,,percent of total billed charges,20% of total billed charges,11.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.92,20,,,percent of total billed charges,20% of total billed charges,11.92,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.74,65,,,percent of total billed charges,65% of total billed charges,38.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.76,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.92,53.67,
SUTURE J341H,6210262,CDM,272,RC,,,outpatient,,,34.32,17.16,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.86,20,,,percent of total billed charges,20% of total billed charges,6.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.86,20,,,percent of total billed charges,20% of total billed charges,6.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.31,65,,,percent of total billed charges,65% of total billed charges,22.31,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.86,53.67,
SUTURE J416H,6210260,CDM,272,RC,,,outpatient,,,31.75,15.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.35,20,,,percent of total billed charges,20% of total billed charges,6.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.35,20,,,percent of total billed charges,20% of total billed charges,6.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.64,65,,,percent of total billed charges,65% of total billed charges,20.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.35,53.67,
SUTURE MCP523H,6215847,CDM,272,RC,,,outpatient,,,40.8,20.4,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.16,20,,,percent of total billed charges,20% of total billed charges,8.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.16,20,,,percent of total billed charges,20% of total billed charges,8.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.52,65,,,percent of total billed charges,65% of total billed charges,26.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.16,53.67,
SUTURE SA85H,6215843,CDM,272,RC,,,outpatient,,,26.1,13.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.22,20,,,percent of total billed charges,20% of total billed charges,5.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.22,20,,,percent of total billed charges,20% of total billed charges,5.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.97,65,,,percent of total billed charges,65% of total billed charges,16.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.22,53.67,
SUTURE TRAY,3250034,CDM,272,RC,,,outpatient,,,63.8,31.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.76,20,,,percent of total billed charges,20% of total billed charges,12.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.76,20,,,percent of total billed charges,20% of total billed charges,12.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.47,65,,,percent of total billed charges,65% of total billed charges,41.47,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.76,53.67,
SUTURE VICRYL 0,6215805,CDM,272,RC,,,outpatient,,,54.91,27.46,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.98,20,,,percent of total billed charges,20% of total billed charges,10.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.98,20,,,percent of total billed charges,20% of total billed charges,10.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.69,65,,,percent of total billed charges,65% of total billed charges,35.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.95,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.98,53.67,
SUTURE VR494,6210261,CDM,272,RC,,,outpatient,,,117.21,58.61,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.44,20,,,percent of total billed charges,20% of total billed charges,23.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.44,20,,,percent of total billed charges,20% of total billed charges,23.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.19,65,,,percent of total billed charges,65% of total billed charges,76.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,70.33,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.44,76.19,
SUTURE Y426H,6215849,CDM,272,RC,,,outpatient,,,60.3,30.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.06,20,,,percent of total billed charges,20% of total billed charges,12.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.06,20,,,percent of total billed charges,20% of total billed charges,12.06,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.2,65,,,percent of total billed charges,65% of total billed charges,39.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.06,53.67,
SUTURE Y494G,6215848,CDM,272,RC,,,outpatient,,,62.65,31.33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.53,20,,,percent of total billed charges,20% of total billed charges,12.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.53,20,,,percent of total billed charges,20% of total billed charges,12.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.72,65,,,percent of total billed charges,65% of total billed charges,40.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.53,53.67,
SUTURE Z371T,6210257,CDM,272,RC,,,outpatient,,,58.67,29.34,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.73,20,,,percent of total billed charges,20% of total billed charges,11.73,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.73,20,,,percent of total billed charges,20% of total billed charges,11.73,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.14,65,,,percent of total billed charges,65% of total billed charges,38.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.73,53.67,
"SUTURE, PS-2,3-0,18""",6215871,CDM,272,RC,,,outpatient,,,60.15,30.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.03,20,,,percent of total billed charges,20% of total billed charges,12.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.03,20,,,percent of total billed charges,20% of total billed charges,12.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.1,65,,,percent of total billed charges,65% of total billed charges,39.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.03,53.67,
SUTURES 1633G,3250327,CDM,272,RC,,,outpatient,,,65.85,32.93,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.17,20,,,percent of total billed charges,20% of total billed charges,13.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.17,20,,,percent of total billed charges,20% of total billed charges,13.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.8,65,,,percent of total billed charges,65% of total billed charges,42.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,53.67,
SUTURES 1661G,3250325,CDM,272,RC,,,outpatient,,,44.55,22.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.91,20,,,percent of total billed charges,20% of total billed charges,8.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.91,20,,,percent of total billed charges,20% of total billed charges,8.91,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.96,65,,,percent of total billed charges,65% of total billed charges,28.96,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.73,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.91,53.67,
SUTURES 1662G,3250477,CDM,272,RC,,,outpatient,,,61.2,30.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.24,20,,,percent of total billed charges,20% of total billed charges,12.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.24,20,,,percent of total billed charges,20% of total billed charges,12.24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.78,65,,,percent of total billed charges,65% of total billed charges,39.78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.24,53.67,
SUTURES 1665G,3250353,CDM,272,RC,,,outpatient,,,45.35,22.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.07,20,,,percent of total billed charges,20% of total billed charges,9.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.07,20,,,percent of total billed charges,20% of total billed charges,9.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.48,65,,,percent of total billed charges,65% of total billed charges,29.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.07,53.67,
SUTURES 424H-CHEST TUBE,3250660,CDM,272,RC,,,outpatient,,,17.2,8.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.44,20,,,percent of total billed charges,20% of total billed charges,3.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.44,20,,,percent of total billed charges,20% of total billed charges,3.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.18,65,,,percent of total billed charges,65% of total billed charges,11.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.44,53.67,
SUTURES 636G,3250357,CDM,272,RC,,,outpatient,,,19.7,9.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.94,20,,,percent of total billed charges,20% of total billed charges,3.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.94,20,,,percent of total billed charges,20% of total billed charges,3.94,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.81,65,,,percent of total billed charges,65% of total billed charges,12.81,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.82,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.94,53.67,
SUTURES 661G,3250445,CDM,272,RC,,,outpatient,,,21.95,10.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.39,20,,,percent of total billed charges,20% of total billed charges,4.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.39,20,,,percent of total billed charges,20% of total billed charges,4.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.27,65,,,percent of total billed charges,65% of total billed charges,14.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.39,53.67,
SUTURES 662G,3250349,CDM,272,RC,,,outpatient,,,37.05,18.53,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.41,20,,,percent of total billed charges,20% of total billed charges,7.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.41,20,,,percent of total billed charges,20% of total billed charges,7.41,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.08,65,,,percent of total billed charges,65% of total billed charges,24.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.23,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.41,53.67,
SUTURES 663G,3250369,CDM,272,RC,,,outpatient,,,34.85,17.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.97,20,,,percent of total billed charges,20% of total billed charges,6.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.97,20,,,percent of total billed charges,20% of total billed charges,6.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.65,65,,,percent of total billed charges,65% of total billed charges,22.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.97,53.67,
SUTURES 8682G,3250521,CDM,272,RC,,,outpatient,,,75.8,37.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.16,20,,,percent of total billed charges,20% of total billed charges,15.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.16,20,,,percent of total billed charges,20% of total billed charges,15.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.27,65,,,percent of total billed charges,65% of total billed charges,49.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.16,53.67,
SUTURES 8697G,3250523,CDM,272,RC,,,outpatient,,,64.3,32.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.86,20,,,percent of total billed charges,20% of total billed charges,12.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.86,20,,,percent of total billed charges,20% of total billed charges,12.86,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.8,65,,,percent of total billed charges,65% of total billed charges,41.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.58,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.86,53.67,
SUTURES 8698G,3250525,CDM,272,RC,,,outpatient,,,55.5,27.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.1,20,,,percent of total billed charges,20% of total billed charges,11.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.1,20,,,percent of total billed charges,20% of total billed charges,11.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.08,65,,,percent of total billed charges,65% of total billed charges,36.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,53.67,
SUTURES CHROMIC GUT PS2,3250622,CDM,272,RC,,,outpatient,,,141.57,70.79,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.31,20,,,percent of total billed charges,20% of total billed charges,28.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.31,20,,,percent of total billed charges,20% of total billed charges,28.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.02,65,,,percent of total billed charges,65% of total billed charges,92.02,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,84.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,28.31,92.02,
SUTURES G-121H,3250359,CDM,272,RC,,,outpatient,,,75.35,37.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.07,20,,,percent of total billed charges,20% of total billed charges,15.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.07,20,,,percent of total billed charges,20% of total billed charges,15.07,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48.98,65,,,percent of total billed charges,65% of total billed charges,48.98,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.07,53.67,
SUTURES H-822H,3250365,CDM,272,RC,,,outpatient,,,52.9,26.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.58,20,,,percent of total billed charges,20% of total billed charges,10.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.58,20,,,percent of total billed charges,20% of total billed charges,10.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.39,65,,,percent of total billed charges,65% of total billed charges,34.39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.58,53.67,
SUTURES J-496G,3250355,CDM,272,RC,,,outpatient,,,52.1,26.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.42,20,,,percent of total billed charges,20% of total billed charges,10.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.42,20,,,percent of total billed charges,20% of total billed charges,10.42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.87,65,,,percent of total billed charges,65% of total billed charges,33.87,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.26,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.42,53.67,
SWALLOWING EVALUATIO,3600041,CDM,440,RC,92610,HCPCS,outpatient,,,120,60,,78,65,,,percent of total billed charges,65% of total billed charges,81.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,20,,,percent of total billed charges,20% of total billed charges,24,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,65,,,percent of total billed charges,65% of total billed charges,78,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,82,
SWALLOWING THERAPY,3600043,CDM,440,RC,92526,HCPCS,outpatient,,,96,48,,62.4,65,,,percent of total billed charges,65% of total billed charges,65.28,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.2,20,,,percent of total billed charges,20% of total billed charges,19.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.4,65,,,percent of total billed charges,65% of total billed charges,62.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,57.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.2,82,
SWINGBED R & B,3020007,CDM,110,RC,,,inpatient,,,504,252,,1750,100,,,per diem,"1750 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2600 for 2 days with a per diem after of 1000 or 3600 for 4 days with a per diem after of 1000. It can also pay at a er diem rate of 600, 1500 or 650 if non med/surg procedures are performed",1837,100,,,per diem,"1837 per day rate for med/surg. If it is a maternity procedure then it will be paid at 2730 for 2 days with a per diem after of 1050 or 3780 for 4 days with a per diem after of 1050. It can also pay at a er diem rate of 630, 1575 or 683 if non med/surg procedures are performed",,,,,other,Not separately reimbursable for physician per contract terms,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,100.8,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,100.8,20,,,percent of total billed charges,20% of total billed charges for inpatient setting,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",856,100,,,per diem,"Med surg per diem rate for inpatient setting. Can also pay differently depending on procedures performed such as nursery, ICU, detox, rehab, maternity, etc",,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,MS-DRG,,other,Pays at CMS DRG weights with UHC base rate markup. See MS-DRG rows. Can also pay at per diem rate of 1200 for rehab or SNF,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,,,APR-DRG,,other,100% of FL Medicaid APR DRG rates. See APR-DRG rows for details,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,1547.7,110,,,per diem,1547.7 per day rate for med/surg rate which is 110% of the Medicare rate. If it is a swing bed stay it will pay at 1435.5 per diem,100.8,1837,
SYRINGE 60 ML IRRIGATION,6210254,CDM,272,RC,,,outpatient,,,2.9,1.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.58,20,,,percent of total billed charges,20% of total billed charges,0.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.58,20,,,percent of total billed charges,20% of total billed charges,0.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.89,65,,,percent of total billed charges,65% of total billed charges,1.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.58,53.67,
SYRINGE EAR/UL 2OZST,3250385,CDM,272,RC,,,outpatient,,,7.15,3.58,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.43,20,,,percent of total billed charges,20% of total billed charges,1.43,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.43,20,,,percent of total billed charges,20% of total billed charges,1.43,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,65,,,percent of total billed charges,65% of total billed charges,4.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.29,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.43,53.67,
T CELLS COUNT,3300613,CDM,302,RC,86359,HCPCS,outpatient,,,99,49.5,,64.35,65,,,percent of total billed charges,65% of total billed charges,67.32,68,,,percent of total billed charges,68% of total billed charges,4.42,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,20,,,percent of total billed charges,20% of total billed charges,19.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,20,,,percent of total billed charges,20% of total billed charges,19.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.35,65,,,percent of total billed charges,65% of total billed charges,64.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,67.32,
T CELLS TOTAL COUNT,3300621,CDM,302,RC,86359,HCPCS,outpatient,,,220,110,,143,65,,,percent of total billed charges,65% of total billed charges,149.6,68,,,percent of total billed charges,68% of total billed charges,4.42,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.42,149.6,
T M JOINTS BIL,3400049,CDM,320,RC,70330,HCPCS,outpatient,,,168,84,,109.2,65,,,percent of total billed charges,65% of total billed charges,114.24,68,,,percent of total billed charges,68% of total billed charges,27.96,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.6,20,,,percent of total billed charges,20% of total billed charges,33.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,109.2,65,,,percent of total billed charges,65% of total billed charges,109.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,100.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.96,180,
T M JOINTS BIL,3440207,CDM,972,RC,70330,HCPCS,outpatient,,,69.3,34.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.9,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.63,110,,,fee schedule,110% of Medicare physician fee schedule,56.63,110,,,fee schedule,110% of Medicare physician fee schedule,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.6,115,,,fee schedule,115% of Medicare physician fee schedule,78.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.12,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.9,235.6,
T PROTEIN CSF,3300381,CDM,301,RC,84157,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,30.6,
T TUBE CHOL INJ,3440427,CDM,972,RC,47500,HCPCS,outpatient,,,110,55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,52.6,
T-TUBE 12 FR/18,6215806,CDM,272,RC,,,outpatient,,,175.51,87.76,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.1,20,,,percent of total billed charges,20% of total billed charges,35.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.1,20,,,percent of total billed charges,20% of total billed charges,35.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114.08,65,,,percent of total billed charges,65% of total billed charges,114.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,105.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.1,114.08,
T-TUBE 14FR/18,6215807,CDM,272,RC,,,outpatient,,,178.09,89.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.62,20,,,percent of total billed charges,20% of total billed charges,35.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.62,20,,,percent of total billed charges,20% of total billed charges,35.62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.76,65,,,percent of total billed charges,65% of total billed charges,115.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.85,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.62,115.76,
T-TUBE CHOL INJ,3400133,CDM,361,RC,47500,HCPCS,outpatient,,,157.5,78.75,,102.38,65,,,percent of total billed charges,65% of total billed charges,107.1,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.5,20,,,percent of total billed charges,20% of total billed charges,31.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.5,20,,,percent of total billed charges,20% of total billed charges,31.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.38,65,,,percent of total billed charges,65% of total billed charges,102.38,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.75,50,,,percent of total billed charges,50% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.5,107.1,
T-TUBE CHOLANGIOGRAM,3400111,CDM,320,RC,74320,HCPCS,outpatient,,,473,236.5,,307.45,65,,,percent of total billed charges,65% of total billed charges,321.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.6,20,,,percent of total billed charges,20% of total billed charges,94.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.6,20,,,percent of total billed charges,20% of total billed charges,94.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,307.45,65,,,percent of total billed charges,65% of total billed charges,307.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,283.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,321.64,
T-TUBE CHOLONGIOGRAM,3440209,CDM,972,RC,74320,HCPCS,outpatient,,,106,53,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,176.4,100,,,case rate,100% of case rate fee,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,176.4,
T3 FREE,3300391,CDM,301,RC,84481,HCPCS,outpatient,,,213,106.5,,138.45,65,,,percent of total billed charges,65% of total billed charges,144.84,68,,,percent of total billed charges,68% of total billed charges,21.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,20,,,percent of total billed charges,20% of total billed charges,42.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,20,,,percent of total billed charges,20% of total billed charges,42.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.45,65,,,percent of total billed charges,65% of total billed charges,138.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,127.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.73,144.84,
T3 RIA,3300261,CDM,301,RC,84480,HCPCS,outpatient,,,173,86.5,,112.45,65,,,percent of total billed charges,65% of total billed charges,117.64,68,,,percent of total billed charges,68% of total billed charges,20.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.6,20,,,percent of total billed charges,20% of total billed charges,34.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.6,20,,,percent of total billed charges,20% of total billed charges,34.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.45,65,,,percent of total billed charges,65% of total billed charges,112.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.12,117.64,
T3 TOTAL,3300387,CDM,301,RC,84480,HCPCS,outpatient,,,105,52.5,,68.25,65,,,percent of total billed charges,65% of total billed charges,71.4,68,,,percent of total billed charges,68% of total billed charges,20.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,20,,,percent of total billed charges,20% of total billed charges,21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,20,,,percent of total billed charges,20% of total billed charges,21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.25,65,,,percent of total billed charges,65% of total billed charges,68.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.12,71.4,
T3 UPTAKE,3300389,CDM,301,RC,84479,HCPCS,outpatient,,,43,21.5,,27.95,65,,,percent of total billed charges,65% of total billed charges,29.24,68,,,percent of total billed charges,68% of total billed charges,9.19,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.6,20,,,percent of total billed charges,20% of total billed charges,8.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.6,20,,,percent of total billed charges,20% of total billed charges,8.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.95,65,,,percent of total billed charges,65% of total billed charges,27.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.6,29.24,
T4 LYMPHOCYTES,3300501,CDM,302,RC,86360,HCPCS,outpatient,,,283,141.5,,183.95,65,,,percent of total billed charges,65% of total billed charges,192.44,68,,,percent of total billed charges,68% of total billed charges,9.66,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.6,20,,,percent of total billed charges,20% of total billed charges,56.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.6,20,,,percent of total billed charges,20% of total billed charges,56.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,183.95,65,,,percent of total billed charges,65% of total billed charges,183.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,141.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,169.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.66,192.44,
T4 TOTAL,3300301,CDM,301,RC,84439,HCPCS,outpatient,,,89,44.5,,57.85,65,,,percent of total billed charges,65% of total billed charges,60.52,68,,,percent of total billed charges,68% of total billed charges,12.8,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.8,20,,,percent of total billed charges,20% of total billed charges,17.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.8,20,,,percent of total billed charges,20% of total billed charges,17.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.85,65,,,percent of total billed charges,65% of total billed charges,57.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.8,60.52,
TACROLIMUS,3300419,CDM,301,RC,80197,HCPCS,outpatient,,,170,85,,110.5,65,,,percent of total billed charges,65% of total billed charges,115.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,20,,,percent of total billed charges,20% of total billed charges,34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,20,,,percent of total billed charges,20% of total billed charges,34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110.5,65,,,percent of total billed charges,65% of total billed charges,110.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34,115.6,
TAMSULOSIN CAP [0.4 MG],3500785,CDM,250,RC,J3490,HCPCS,outpatient,,,21.05,10.53,,13.68,65,,,percent of total billed charges,65% of total billed charges,14.31,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.21,20,,,percent of total billed charges,20% of total billed charges,4.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.21,20,,,percent of total billed charges,20% of total billed charges,4.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.68,65,,,percent of total billed charges,65% of total billed charges,13.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.21,53.67,
TANGENTIAL BX SKIN SING LESION P,3462007,CDM,982,RC,11102,HCPCS,outpatient,,,350,175,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.38,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.05,110,,,fee schedule,110% of Medicare physician fee schedule,42.05,110,,,fee schedule,110% of Medicare physician fee schedule,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.96,115,,,fee schedule,115% of Medicare physician fee schedule,77.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.38,77.98,
TANGNTL BX SKIN SING LESION PRO FEE,3700307,CDM,983,RC,11102,HCPCS,outpatient,,,125,62.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.38,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.05,110,,,fee schedule,110% of Medicare physician fee schedule,42.05,110,,,fee schedule,110% of Medicare physician fee schedule,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.96,115,,,fee schedule,115% of Medicare physician fee schedule,77.98,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,25.38,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.36,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,25.38,77.98,
TANGNTL BX SKIN SINGLE LESION,3700306,CDM,510,RC,11102,HCPCS,outpatient,,,305,152.5,,198.25,65,,,percent of total billed charges,65% of total billed charges,207.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61,20,,,percent of total billed charges,20% of total billed charges,61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61,20,,,percent of total billed charges,20% of total billed charges,61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,198.25,65,,,percent of total billed charges,65% of total billed charges,198.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,183,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,207.4,
TEGADERM FOAM 4X4,6215804,CDM,272,RC,,,outpatient,,,39.01,19.51,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.8,20,,,percent of total billed charges,20% of total billed charges,7.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.8,20,,,percent of total billed charges,20% of total billed charges,7.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.36,65,,,percent of total billed charges,65% of total billed charges,25.36,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.8,53.67,
TEGADERM IV DRESSING,3250497,CDM,272,RC,,,outpatient,,,6.45,3.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.29,20,,,percent of total billed charges,20% of total billed charges,1.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.29,20,,,percent of total billed charges,20% of total billed charges,1.29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.19,65,,,percent of total billed charges,65% of total billed charges,4.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.29,53.67,
TELEMETRY POUCH,3250117,CDM,271,RC,,,outpatient,,,18.55,9.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.71,20,,,percent of total billed charges,20% of total billed charges,3.71,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.71,20,,,percent of total billed charges,20% of total billed charges,3.71,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.06,65,,,percent of total billed charges,65% of total billed charges,12.06,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.13,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.71,53.67,
TELFA 3X4 NON-AD,3250397,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
TELFA 3X8 NON ADH,3250321,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
TEMAZEPAM [30 MG] CAP,3521927,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
TEMAZEPAM CAP [15 MG],3500786,CDM,250,RC,J3490,HCPCS,outpatient,,,7.75,3.88,,5.04,65,,,percent of total billed charges,65% of total billed charges,5.27,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
TENECTEPLAS INJ [50 MG],3500787,CDM,636,RC,J3101,HCPCS,outpatient,,,5204.2,2602.1,,3382.73,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,3538.86,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1040.84,20,,,percent of total billed charges,20% of total billed charges,1040.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1040.84,20,,,percent of total billed charges,20% of total billed charges,1040.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4163.36,80,,,case rate,80% for high cost drug carve out,4423.57,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3122.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1040.84,4423.57,
TERAZOSIN CAP [1 MG],3500788,CDM,250,RC,J3490,HCPCS,outpatient,,,8.05,4.03,,5.23,65,,,percent of total billed charges,65% of total billed charges,5.47,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.61,20,,,percent of total billed charges,20% of total billed charges,1.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.61,20,,,percent of total billed charges,20% of total billed charges,1.61,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.23,65,,,percent of total billed charges,65% of total billed charges,5.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.83,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.61,53.67,
TERBINAFINE 250MG TAB,3500418,CDM,250,RC,,,outpatient,,,65.15,32.58,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.03,20,,,percent of total billed charges,20% of total billed charges,13.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.03,20,,,percent of total billed charges,20% of total billed charges,13.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.35,65,,,percent of total billed charges,65% of total billed charges,42.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.03,53.67,
"TESTOSTERONE, FREE",3300429,CDM,301,RC,84402,HCPCS,outpatient,,,180,90,,117,65,,,percent of total billed charges,65% of total billed charges,122.4,68,,,percent of total billed charges,68% of total billed charges,36.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,20,,,percent of total billed charges,20% of total billed charges,36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,20,,,percent of total billed charges,20% of total billed charges,36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,65,,,percent of total billed charges,65% of total billed charges,117,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,122.4,
"TESTOSTERONE, TOTAL",3300243,CDM,301,RC,84403,HCPCS,outpatient,,,115,57.5,,74.75,65,,,percent of total billed charges,65% of total billed charges,78.2,68,,,percent of total billed charges,68% of total billed charges,36.64,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23,20,,,percent of total billed charges,20% of total billed charges,23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23,20,,,percent of total billed charges,20% of total billed charges,23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.75,65,,,percent of total billed charges,65% of total billed charges,74.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23,78.2,
TETRACAINE HYDROCHLORIDE EYEDROPS 0.5%,3501115,CDM,250,RC,,,outpatient,,,72,36,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.4,20,,,percent of total billed charges,20% of total billed charges,14.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.8,65,,,percent of total billed charges,65% of total billed charges,46.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.4,53.67,
THAWING FFP EA UNIT,3300805,CDM,309,RC,86927,HCPCS,outpatient,,,190,95,,123.5,65,,,percent of total billed charges,65% of total billed charges,129.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,20,,,percent of total billed charges,20% of total billed charges,38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,123.5,65,,,percent of total billed charges,65% of total billed charges,123.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,114,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38,129.2,
THEOPHYLLINE,3300145,CDM,301,RC,80198,HCPCS,outpatient,,,76,38,,49.4,65,,,percent of total billed charges,65% of total billed charges,51.68,68,,,percent of total billed charges,68% of total billed charges,20.09,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.2,20,,,percent of total billed charges,20% of total billed charges,15.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.2,20,,,percent of total billed charges,20% of total billed charges,15.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.4,65,,,percent of total billed charges,65% of total billed charges,49.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.2,51.68,
THERAPEU ACTIVITY/15MIN,3600015,CDM,420,RC,97530,HCPCS,outpatient,,,101,50.5,,65.65,65,,,percent of total billed charges,65% of total billed charges,68.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.65,65,,,percent of total billed charges,65% of total billed charges,65.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,82,
THIAMINE-VIT B1,3300331,CDM,301,RC,84425,HCPCS,outpatient,,,170,85,,110.5,65,,,percent of total billed charges,65% of total billed charges,115.6,68,,,percent of total billed charges,68% of total billed charges,12.09,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,20,,,percent of total billed charges,20% of total billed charges,34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,20,,,percent of total billed charges,20% of total billed charges,34,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110.5,65,,,percent of total billed charges,65% of total billed charges,110.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,85,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,102,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.09,115.6,
THORA SEAL CHEST DRAINAGE UNIT,3250418,CDM,272,RC,,,outpatient,,,254.1,127.05,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.82,20,,,percent of total billed charges,20% of total billed charges,50.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.82,20,,,percent of total billed charges,20% of total billed charges,50.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,165.17,65,,,percent of total billed charges,65% of total billed charges,165.17,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,152.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,50.82,165.17,
THORACENTESIS,3020015,CDM,360,RC,32554,HCPCS,outpatient,,,437,218.5,,284.05,65,,,percent of total billed charges,65% of total billed charges,297.16,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,284.05,65,,,percent of total billed charges,65% of total billed charges,284.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,312,
THORACENTESIS,3231117,CDM,450,RC,32554,HCPCS,outpatient,,,437,218.5,,284.05,65,,,percent of total billed charges,65% of total billed charges,297.16,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.4,20,,,percent of total billed charges,20% of total billed charges,87.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,284.05,65,,,percent of total billed charges,65% of total billed charges,284.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,262.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,312,
THORACENTESIS NEEDLE/CATH W/IMAGING,3462072,CDM,982,RC,32555,HCPCS,outpatient,,,406,203,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.06,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,121.35,110,,,fee schedule,110% of Medicare physician fee schedule,121.35,110,,,fee schedule,110% of Medicare physician fee schedule,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.87,115,,,fee schedule,115% of Medicare physician fee schedule,126.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.06,139.55,
THORACENTESIS NEEDLE/CATH W/IMAGING,3700080,CDM,360,RC,32555,HCPCS,outpatient,,,734,367,,477.1,65,,,percent of total billed charges,65% of total billed charges,499.12,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.8,20,,,percent of total billed charges,20% of total billed charges,146.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,146.8,20,,,percent of total billed charges,20% of total billed charges,146.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,477.1,65,,,percent of total billed charges,65% of total billed charges,477.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,440.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,499.12,
THORACENTESIS NEEDLE/CATH W/O IMAGING,3462071,CDM,982,RC,32554,HCPCS,outpatient,,,292,146,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,60.46,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,98.98,110,,,fee schedule,110% of Medicare physician fee schedule,98.98,110,,,fee schedule,110% of Medicare physician fee schedule,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.48,115,,,fee schedule,115% of Medicare physician fee schedule,113.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.82,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.46,113.82,
THORACENTESIS w/IMAGING,3700321,CDM,510,RC,32555,HCPCS,outpatient,,,374,187,,243.1,65,,,percent of total billed charges,65% of total billed charges,254.32,68,,,percent of total billed charges,68% of total billed charges,419,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.8,20,,,percent of total billed charges,20% of total billed charges,74.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74.8,20,,,percent of total billed charges,20% of total billed charges,74.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,243.1,65,,,percent of total billed charges,65% of total billed charges,243.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,224.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,419,
THORACENTESIS w/IMAGING PRO,3700322,CDM,983,RC,32555,HCPCS,outpatient,,,190,95,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.06,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,121.35,110,,,fee schedule,110% of Medicare physician fee schedule,121.35,110,,,fee schedule,110% of Medicare physician fee schedule,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,126.87,115,,,fee schedule,115% of Medicare physician fee schedule,126.66,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,139.55,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.06,139.55,
THORACIC SPINE 3VIEW,3400045,CDM,320,RC,72072,HCPCS,outpatient,,,181.5,90.75,,117.98,65,,,percent of total billed charges,65% of total billed charges,123.42,68,,,percent of total billed charges,68% of total billed charges,24.76,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.3,20,,,percent of total billed charges,20% of total billed charges,36.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.3,20,,,percent of total billed charges,20% of total billed charges,36.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117.98,65,,,percent of total billed charges,65% of total billed charges,117.98,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.76,180,
THORACIC SPINE/SWIM,3440211,CDM,972,RC,72072,HCPCS,outpatient,,,58.3,29.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.82,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.24,110,,,fee schedule,110% of Medicare physician fee schedule,42.24,110,,,fee schedule,110% of Medicare physician fee schedule,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,220.56,115,,,fee schedule,115% of Medicare physician fee schedule,71.42,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.82,220.56,
THORASCOSTOMY (CHEST TUBE PLACEMENT),3231133,CDM,450,RC,32557,HCPCS,outpatient,,,651,325.5,,423.15,65,,,percent of total billed charges,65% of total billed charges,442.68,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.2,20,,,percent of total billed charges,20% of total billed charges,130.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.2,20,,,percent of total billed charges,20% of total billed charges,130.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,423.15,65,,,percent of total billed charges,65% of total billed charges,423.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,296,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,442.68,
THROAT CULTURE,3300701,CDM,306,RC,87081,HCPCS,outpatient,,,41,20.5,,26.65,65,,,percent of total billed charges,65% of total billed charges,27.88,68,,,percent of total billed charges,68% of total billed charges,9.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.65,65,,,percent of total billed charges,65% of total billed charges,26.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.2,27.88,
"Throat Culture, SO",3300905,CDM,306,RC,87081,HCPCS,outpatient,,,41,20.5,,26.65,65,,,percent of total billed charges,65% of total billed charges,27.88,68,,,percent of total billed charges,68% of total billed charges,9.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.65,65,,,percent of total billed charges,65% of total billed charges,26.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.2,27.88,
THROMBIN,3300673,CDM,305,RC,85670,HCPCS,outpatient,,,68,34,,44.2,65,,,percent of total billed charges,65% of total billed charges,46.24,68,,,percent of total billed charges,68% of total billed charges,8.03,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.6,20,,,percent of total billed charges,20% of total billed charges,13.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.2,65,,,percent of total billed charges,65% of total billed charges,44.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,46.24,
THROMBOLYSIS,3231125,CDM,450,RC,92977,HCPCS,outpatient,,,830,415,,539.5,65,,,percent of total billed charges,65% of total billed charges,564.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,166,20,,,percent of total billed charges,20% of total billed charges,166,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,166,20,,,percent of total billed charges,20% of total billed charges,166,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,539.5,65,,,percent of total billed charges,65% of total billed charges,539.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,498,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,564.4,
THRPTC EX 15 MIN,3600003,CDM,420,RC,97110,HCPCS,outpatient,,,106,53,,68.9,65,,,percent of total billed charges,65% of total billed charges,72.08,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.2,20,,,percent of total billed charges,20% of total billed charges,21.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.2,20,,,percent of total billed charges,20% of total billed charges,21.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,68.9,65,,,percent of total billed charges,65% of total billed charges,68.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,63.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.2,82,
"Thyroglobulin, Quant",3300911,CDM,302,RC,86800,HCPCS,outpatient,,,177,88.5,,115.05,65,,,percent of total billed charges,65% of total billed charges,120.36,68,,,percent of total billed charges,68% of total billed charges,22.57,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,20,,,percent of total billed charges,20% of total billed charges,35.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.4,20,,,percent of total billed charges,20% of total billed charges,35.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.05,65,,,percent of total billed charges,65% of total billed charges,115.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,88.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,106.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.57,120.36,
THYROID STIM HORMONE,3300119,CDM,301,RC,84443,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,23.84,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,61.2,
THYROID STIMULAT IG,3300329,CDM,301,RC,84445,HCPCS,outpatient,,,324,162,,210.6,65,,,percent of total billed charges,65% of total billed charges,220.32,68,,,percent of total billed charges,68% of total billed charges,24.05,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,20,,,percent of total billed charges,20% of total billed charges,64.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.8,20,,,percent of total billed charges,20% of total billed charges,64.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210.6,65,,,percent of total billed charges,65% of total billed charges,210.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,162,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,194.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.05,220.32,
THYROXINE BINDING GL,3300327,CDM,301,RC,84442,HCPCS,outpatient,,,100,50,,65,65,,,percent of total billed charges,65% of total billed charges,68,68,,,percent of total billed charges,68% of total billed charges,20.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,65,,,percent of total billed charges,65% of total billed charges,65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20,68,
THYROXINE FREE (T4),3300121,CDM,301,RC,84439,HCPCS,outpatient,,,77,38.5,,50.05,65,,,percent of total billed charges,65% of total billed charges,52.36,68,,,percent of total billed charges,68% of total billed charges,12.8,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.4,20,,,percent of total billed charges,20% of total billed charges,15.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.4,20,,,percent of total billed charges,20% of total billed charges,15.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.05,65,,,percent of total billed charges,65% of total billed charges,50.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.8,52.36,
THYROXINE; TOTAL,3300865,CDM,301,RC,84436,HCPCS,outpatient,,,12,6,,7.8,65,,,percent of total billed charges,65% of total billed charges,8.16,68,,,percent of total billed charges,68% of total billed charges,9.76,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,20,,,percent of total billed charges,20% of total billed charges,2.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.8,65,,,percent of total billed charges,65% of total billed charges,7.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,9.76,
TIB/FIB BIL MIN 2 V,3440213,CDM,972,RC,73590,HCPCS,outpatient,,,80.3,40.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.02,110,,,fee schedule,110% of Medicare physician fee schedule,34.02,110,,,fee schedule,110% of Medicare physician fee schedule,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.97,115,,,fee schedule,115% of Medicare physician fee schedule,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.72,211.97,
TIB/FIB L MIN 2 V,3440215,CDM,972,RC,73590,HCPCS,outpatient,,,46.2,23.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.02,110,,,fee schedule,110% of Medicare physician fee schedule,34.02,110,,,fee schedule,110% of Medicare physician fee schedule,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.97,115,,,fee schedule,115% of Medicare physician fee schedule,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.72,211.97,
TIB/FIB RT MIN 2 V,3440217,CDM,972,RC,73590,HCPCS,outpatient,,,46.2,23.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.02,110,,,fee schedule,110% of Medicare physician fee schedule,34.02,110,,,fee schedule,110% of Medicare physician fee schedule,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.97,115,,,fee schedule,115% of Medicare physician fee schedule,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.72,211.97,
TIB/FIB-BIL MIN 2VW,3400100,CDM,320,RC,73590,HCPCS,outpatient,,,210,105,,136.5,65,,,percent of total billed charges,65% of total billed charges,142.8,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,20,,,percent of total billed charges,20% of total billed charges,42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,20,,,percent of total billed charges,20% of total billed charges,42,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.5,65,,,percent of total billed charges,65% of total billed charges,136.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,126,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
TIB/FIB-LT MIN 2VW,3400024,CDM,320,RC,73590,HCPCS,outpatient,,,192.5,96.25,,125.13,65,,,percent of total billed charges,65% of total billed charges,130.9,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,20,,,percent of total billed charges,20% of total billed charges,38.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,20,,,percent of total billed charges,20% of total billed charges,38.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.13,65,,,percent of total billed charges,65% of total billed charges,125.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
TIB/FIB-RT MIN 2VW,3400099,CDM,320,RC,73590,HCPCS,outpatient,,,192.5,96.25,,125.13,65,,,percent of total billed charges,65% of total billed charges,130.9,68,,,percent of total billed charges,68% of total billed charges,17.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,20,,,percent of total billed charges,20% of total billed charges,38.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,20,,,percent of total billed charges,20% of total billed charges,38.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.13,65,,,percent of total billed charges,65% of total billed charges,125.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.41,180,
TIBC,3300295,CDM,301,RC,83550,HCPCS,outpatient,,,50,25,,32.5,65,,,percent of total billed charges,65% of total billed charges,34,68,,,percent of total billed charges,68% of total billed charges,12.4,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10,34,
TIMOLOL MAL 0.5% [EYE],3500797,CDM,250,RC,,,outpatient,,,34,17,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.8,20,,,percent of total billed charges,20% of total billed charges,6.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.1,65,,,percent of total billed charges,65% of total billed charges,22.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.8,53.67,
TIN TAB [80 MG],3501048,CDM,250,RC,J3490,HCPCS,outpatient,,,41.75,20.88,,27.14,65,,,percent of total billed charges,65% of total billed charges,28.39,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.35,20,,,percent of total billed charges,20% of total billed charges,8.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.35,20,,,percent of total billed charges,20% of total billed charges,8.35,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.14,65,,,percent of total billed charges,65% of total billed charges,27.14,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.05,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.35,53.67,
TIOTROPIUM MDI,3500798,CDM,250,RC,J3490,HCPCS,outpatient,,,316.4,158.2,,205.66,65,,,percent of total billed charges,65% of total billed charges,215.15,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.28,20,,,percent of total billed charges,20% of total billed charges,63.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.28,20,,,percent of total billed charges,20% of total billed charges,63.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205.66,65,,,percent of total billed charges,65% of total billed charges,205.66,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,189.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,215.15,
TIZANIDINE TAB [4 MG],3500799,CDM,250,RC,J3490,HCPCS,outpatient,,,8.85,4.43,,5.75,65,,,percent of total billed charges,65% of total billed charges,6.02,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.77,20,,,percent of total billed charges,20% of total billed charges,1.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.77,20,,,percent of total billed charges,20% of total billed charges,1.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.75,65,,,percent of total billed charges,65% of total billed charges,5.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.77,53.67,
TNKASE [ VIAL] 1 MG,3500800,CDM,636,RC,J3101,HCPCS,outpatient,,,10820.85,5410.43,,7033.55,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,7358.18,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2164.17,20,,,percent of total billed charges,20% of total billed charges,2164.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2164.17,20,,,percent of total billed charges,20% of total billed charges,2164.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8656.68,80,,,case rate,80% for high cost drug carve out,9197.72,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6492.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2164.17,9197.72,
TOBRAMYCIN,3300260,CDM,301,RC,80200,HCPCS,outpatient,,,85,42.5,,55.25,65,,,percent of total billed charges,65% of total billed charges,57.8,68,,,percent of total billed charges,68% of total billed charges,22.88,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.25,65,,,percent of total billed charges,65% of total billed charges,55.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17,57.8,
TOBRAMYCIN 0.3% DRP [EYE],3500801,CDM,250,RC,J3490,HCPCS,outpatient,,,72.8,36.4,,47.32,65,,,percent of total billed charges,65% of total billed charges,49.5,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.56,20,,,percent of total billed charges,20% of total billed charges,14.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.56,20,,,percent of total billed charges,20% of total billed charges,14.56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,47.32,65,,,percent of total billed charges,65% of total billed charges,47.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.68,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.56,53.67,
TOBRAMYCIN PEAK,3300259,CDM,301,RC,80200,HCPCS,outpatient,,,85,42.5,,55.25,65,,,percent of total billed charges,65% of total billed charges,57.8,68,,,percent of total billed charges,68% of total billed charges,22.88,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.25,65,,,percent of total billed charges,65% of total billed charges,55.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17,57.8,
TOBRAMYCIN TROUGH,3300262,CDM,301,RC,80200,HCPCS,outpatient,,,85,42.5,,55.25,65,,,percent of total billed charges,65% of total billed charges,57.8,68,,,percent of total billed charges,68% of total billed charges,22.88,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17,20,,,percent of total billed charges,20% of total billed charges,17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,55.25,65,,,percent of total billed charges,65% of total billed charges,55.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17,57.8,
TOBRAMYCIN/ DEX DRP [EYE],3500803,CDM,250,RC,,,outpatient,,,121.4,60.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.28,20,,,percent of total billed charges,20% of total billed charges,24.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.28,20,,,percent of total billed charges,20% of total billed charges,24.28,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78.91,65,,,percent of total billed charges,65% of total billed charges,78.91,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,72.84,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.28,78.91,
TOCOLIZUMAB 20 MG/ML,3521948,CDM,636,RC,J3262,HCPCS,outpatient,,,2006.05,1003.03,,1303.93,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,1364.11,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,401.21,20,,,percent of total billed charges,20% of total billed charges,401.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,401.21,20,,,percent of total billed charges,20% of total billed charges,401.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1604.84,80,,,case rate,80% for high cost drug carve out,1705.14,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1203.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,401.21,1705.14,
TOE-L MIN 2 V,3440219,CDM,972,RC,73660,HCPCS,outpatient,,,37.4,18.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.5,110,,,fee schedule,110% of Medicare physician fee schedule,31.5,110,,,fee schedule,110% of Medicare physician fee schedule,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.34,115,,,fee schedule,115% of Medicare physician fee schedule,67.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.33,209.34,
TOE-L MIN 2VW,3400050,CDM,320,RC,73660,HCPCS,outpatient,,,145,72.5,,94.25,65,,,percent of total billed charges,65% of total billed charges,98.6,68,,,percent of total billed charges,68% of total billed charges,14.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,20,,,percent of total billed charges,20% of total billed charges,29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,20,,,percent of total billed charges,20% of total billed charges,29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.25,65,,,percent of total billed charges,65% of total billed charges,94.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,180,
TOE-R MIN 2 V,3440221,CDM,972,RC,73660,HCPCS,outpatient,,,37.4,18.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,31.5,110,,,fee schedule,110% of Medicare physician fee schedule,31.5,110,,,fee schedule,110% of Medicare physician fee schedule,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,209.34,115,,,fee schedule,115% of Medicare physician fee schedule,67.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,36.23,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.33,209.34,
TOE-RT MIN 2 VW,3400101,CDM,320,RC,73660,HCPCS,outpatient,,,145,72.5,,94.25,65,,,percent of total billed charges,65% of total billed charges,98.6,68,,,percent of total billed charges,68% of total billed charges,14.22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,20,,,percent of total billed charges,20% of total billed charges,29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,20,,,percent of total billed charges,20% of total billed charges,29,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.25,65,,,percent of total billed charges,65% of total billed charges,94.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,87,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.22,180,
TOFRANIL,3300161,CDM,301,RC,80174,HCPCS,outpatient,,,112,56,,72.8,65,,,percent of total billed charges,65% of total billed charges,76.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.4,20,,,percent of total billed charges,20% of total billed charges,22.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.8,65,,,percent of total billed charges,65% of total billed charges,72.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.4,76.16,
TOLTERODINE LA CAP [4 MG],3500806,CDM,250,RC,,,outpatient,,,40.15,20.08,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.03,20,,,percent of total billed charges,20% of total billed charges,8.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.03,20,,,percent of total billed charges,20% of total billed charges,8.03,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.1,65,,,percent of total billed charges,65% of total billed charges,26.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.09,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.03,53.67,
TONGUE DEP STERILE,3250399,CDM,272,RC,,,outpatient,,,3.3,1.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.66,20,,,percent of total billed charges,20% of total billed charges,0.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.15,65,,,percent of total billed charges,65% of total billed charges,2.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.66,53.67,
TOPIRAMATE,3300435,CDM,301,RC,80201,HCPCS,outpatient,,,180,90,,117,65,,,percent of total billed charges,65% of total billed charges,122.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,20,,,percent of total billed charges,20% of total billed charges,36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,20,,,percent of total billed charges,20% of total billed charges,36,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,117,65,,,percent of total billed charges,65% of total billed charges,117,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,108,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,122.4,
TOPIRAMATE TAB  [100 MG],3501005,CDM,250,RC,,,outpatient,,,31,15.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.2,20,,,percent of total billed charges,20% of total billed charges,6.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.15,65,,,percent of total billed charges,65% of total billed charges,20.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.2,53.67,
TOPIRAMATE TAB  [25 MG],3500807,CDM,250,RC,,,outpatient,,,10.5,5.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.1,20,,,percent of total billed charges,20% of total billed charges,2.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.1,20,,,percent of total billed charges,20% of total billed charges,2.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.83,65,,,percent of total billed charges,65% of total billed charges,6.83,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.1,53.67,
TORSEMIDE TAB [100 MG],3521946,CDM,250,RC,,,outpatient,,,14.5,7.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.9,20,,,percent of total billed charges,20% of total billed charges,2.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.9,20,,,percent of total billed charges,20% of total billed charges,2.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.43,65,,,percent of total billed charges,65% of total billed charges,9.43,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.9,53.67,
TORSEMIDE TAB [20 MG],3500808,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
TOTAL PROTEIN SERUM,3300065,CDM,301,RC,84155,HCPCS,outpatient,,,30,15,,19.5,65,,,percent of total billed charges,65% of total billed charges,20.4,68,,,percent of total billed charges,68% of total billed charges,5.2,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.2,20.4,
TOUCH PREP,3300837,CDM,311,RC,88161,HCPCS,outpatient,,,77,38.5,,50.05,65,,,percent of total billed charges,65% of total billed charges,52.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.4,20,,,percent of total billed charges,20% of total billed charges,15.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.4,20,,,percent of total billed charges,20% of total billed charges,15.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.05,65,,,percent of total billed charges,65% of total billed charges,50.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.4,52.36,
TOX CITIZENS CONTRACT,3300455,CDM,301,RC,80100,HCPCS,outpatient,,,35,17.5,,22.75,65,,,percent of total billed charges,65% of total billed charges,23.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,20,,,percent of total billed charges,20% of total billed charges,7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.75,65,,,percent of total billed charges,65% of total billed charges,22.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7,23.8,
TOX COLLECT ONLY CONTRACT,3300345,CDM,301,RC,99001,HCPCS,outpatient,,,20,10,,13,65,,,percent of total billed charges,65% of total billed charges,13.6,68,,,percent of total billed charges,68% of total billed charges,3,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,13.6,
TOX MADISON CO CONTRACT,3300453,CDM,301,RC,80100,HCPCS,outpatient,,,30,15,,19.5,65,,,percent of total billed charges,65% of total billed charges,20.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,20,,,percent of total billed charges,20% of total billed charges,6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.5,65,,,percent of total billed charges,65% of total billed charges,19.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,20.4,
TOX ROUTINE CONTRACT,3300217,CDM,301,RC,80305,HCPCS,outpatient,,,45,22.5,,29.25,65,,,percent of total billed charges,65% of total billed charges,30.6,68,,,percent of total billed charges,68% of total billed charges,19.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,20,,,percent of total billed charges,20% of total billed charges,9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.25,65,,,percent of total billed charges,65% of total billed charges,29.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,30.6,
TOXICOLOGY W/C,3300219,CDM,301,RC,80102,HCPCS,outpatient,,,67,33.5,,43.55,65,,,percent of total billed charges,65% of total billed charges,45.56,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.4,20,,,percent of total billed charges,20% of total billed charges,13.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.4,20,,,percent of total billed charges,20% of total billed charges,13.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.55,65,,,percent of total billed charges,65% of total billed charges,43.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,40.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.4,45.56,
TOXOPLASMA IGM,3300543,CDM,302,RC,86778,HCPCS,outpatient,,,172,86,,111.8,65,,,percent of total billed charges,65% of total billed charges,116.96,68,,,percent of total billed charges,68% of total billed charges,20.44,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.4,20,,,percent of total billed charges,20% of total billed charges,34.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.4,20,,,percent of total billed charges,20% of total billed charges,34.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111.8,65,,,percent of total billed charges,65% of total billed charges,111.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,103.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.44,116.96,
TRACH REPLACEMENT,3170099,CDM,410,RC,31502,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,178,
TRACHE S24 TUBE,4000048,CDM,272,RC,,,outpatient,,,320.45,160.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.09,20,,,percent of total billed charges,20% of total billed charges,64.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.09,20,,,percent of total billed charges,20% of total billed charges,64.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,208.29,65,,,percent of total billed charges,65% of total billed charges,208.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,208.29,
TRACHE TUBE S26,4000049,CDM,272,RC,,,outpatient,,,320.45,160.23,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.09,20,,,percent of total billed charges,20% of total billed charges,64.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.09,20,,,percent of total billed charges,20% of total billed charges,64.09,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,208.29,65,,,percent of total billed charges,65% of total billed charges,208.29,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,192.27,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,208.29,
TRACHEOSTOMY,3231121,CDM,450,RC,31603,HCPCS,outpatient,,,1089,544.5,,707.85,65,,,percent of total billed charges,65% of total billed charges,740.52,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,217.8,20,,,percent of total billed charges,20% of total billed charges,217.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,217.8,20,,,percent of total billed charges,20% of total billed charges,217.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,707.85,65,,,percent of total billed charges,65% of total billed charges,707.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,653.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,740.52,
TRAMADOL TAB [50 MG],3500809,CDM,250,RC,,,outpatient,,,7.75,3.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.55,20,,,percent of total billed charges,20% of total billed charges,1.55,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.04,65,,,percent of total billed charges,65% of total billed charges,5.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.65,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.55,53.67,
TRANEXAMIC ACID 100MG/ML 10 ML SDU,3521951,CDM,636,RC,J3490,HCPCS,outpatient,,,112.3,56.15,,,,,,other,Not reimbursable per contract ,76.36,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.46,20,,,percent of total billed charges,20% of total billed charges,22.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.46,20,,,percent of total billed charges,20% of total billed charges,22.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,89.84,80,,,case rate,80% for high cost drug carve out,95.46,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,67.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.46,95.46,
TRANSFERRIN,3300237,CDM,301,RC,84466,HCPCS,outpatient,,,71,35.5,,46.15,65,,,percent of total billed charges,65% of total billed charges,48.28,68,,,percent of total billed charges,68% of total billed charges,18.13,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.15,65,,,percent of total billed charges,65% of total billed charges,46.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,48.28,
TRAVOPROST DRP [EYE],3500810,CDM,250,RC,,,outpatient,,,432.2,216.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.44,20,,,percent of total billed charges,20% of total billed charges,86.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.44,20,,,percent of total billed charges,20% of total billed charges,86.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,280.93,65,,,percent of total billed charges,65% of total billed charges,280.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,259.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,280.93,
TRAY EYE OR EAR,3250075,CDM,271,RC,,,outpatient,,,17.25,8.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,20,,,percent of total billed charges,20% of total billed charges,3.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,20,,,percent of total billed charges,20% of total billed charges,3.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.21,65,,,percent of total billed charges,65% of total billed charges,11.21,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,53.67,
TRAY SUTURE REMOVAL,3250505,CDM,272,RC,,,outpatient,,,12.2,6.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.44,20,,,percent of total billed charges,20% of total billed charges,2.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.44,20,,,percent of total billed charges,20% of total billed charges,2.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.93,65,,,percent of total billed charges,65% of total billed charges,7.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.44,53.67,
TRAY THORACENTISIS,3250465,CDM,272,RC,,,outpatient,,,192.5,96.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,20,,,percent of total billed charges,20% of total billed charges,38.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,20,,,percent of total billed charges,20% of total billed charges,38.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.13,65,,,percent of total billed charges,65% of total billed charges,125.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.5,125.13,
TRAY TRACH CARE,3250341,CDM,272,RC,,,outpatient,,,33,16.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.6,20,,,percent of total billed charges,20% of total billed charges,6.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.6,20,,,percent of total billed charges,20% of total billed charges,6.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.45,65,,,percent of total billed charges,65% of total billed charges,21.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.6,53.67,
TRAZODONE TAB [50 MG],3500812,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
TREPONEMA PALLIDUM,3300587,CDM,302,RC,86780,HCPCS,outpatient,,,128.23,64.12,,83.35,65,,,percent of total billed charges,65% of total billed charges,87.2,68,,,percent of total billed charges,68% of total billed charges,18.79,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.65,20,,,percent of total billed charges,20% of total billed charges,25.65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.65,20,,,percent of total billed charges,20% of total billed charges,25.65,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.35,65,,,percent of total billed charges,65% of total billed charges,83.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.12,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,76.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.79,87.2,
TRIAMCINOLONE 0.5% OINT [,3500818,CDM,250,RC,,,outpatient,,,20.2,10.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.04,20,,,percent of total billed charges,20% of total billed charges,4.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.04,20,,,percent of total billed charges,20% of total billed charges,4.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.13,65,,,percent of total billed charges,65% of total billed charges,13.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.04,53.67,
TRIAMTER/ HCTZ TAB [37.5-,3500820,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
TRIGLYCERIDE,3300117,CDM,301,RC,84478,HCPCS,outpatient,,,25,12.5,,16.25,65,,,percent of total billed charges,65% of total billed charges,17,68,,,percent of total billed charges,68% of total billed charges,8.16,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,17,
TRIHEXYPHENIDYL HCL  TAB,3500966,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
TRILIPTEL,3300415,CDM,301,RC,82491,HCPCS,outpatient,,,70,35,,45.5,65,,,percent of total billed charges,65% of total billed charges,47.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,65,,,percent of total billed charges,65% of total billed charges,45.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,47.6,
TRIMETHOPRIM TAB [100 MG],3500980,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
TRIPLE ANTIBIO OINT,3511017,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
TRIPLE ANTIBIOTIC OINT,3501090,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
TRIPTORELIN PAMOATE,5000001,CDM,636,RC,J3315,HCPCS,outpatient,,,1970.71,985.36,,1280.96,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,1340.08,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,394.14,20,,,percent of total billed charges,20% of total billed charges,394.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,394.14,20,,,percent of total billed charges,20% of total billed charges,394.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1576.57,80,,,case rate,80% for high cost drug carve out,1675.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1182.43,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,394.14,1675.1,
TROPONIN I,3300363,CDM,301,RC,84484,HCPCS,outpatient,,,65,32.5,,42.25,65,,,percent of total billed charges,65% of total billed charges,44.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,20,,,percent of total billed charges,20% of total billed charges,13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,20,,,percent of total billed charges,20% of total billed charges,13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.25,65,,,percent of total billed charges,65% of total billed charges,42.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13,44.2,
TSH with Reflex to Free T4,3300939,CDM,300,RC,84443,HCPCS,outpatient,,,14,7,,9.1,65,,,percent of total billed charges,65% of total billed charges,9.52,68,,,percent of total billed charges,68% of total billed charges,23.84,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.8,20,,,percent of total billed charges,20% of total billed charges,2.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.1,65,,,percent of total billed charges,65% of total billed charges,9.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.8,23.84,
TSH/REFLEX,3300897,CDM,301,RC,84443,HCPCS,outpatient,,,90,45,,58.5,65,,,percent of total billed charges,65% of total billed charges,61.2,68,,,percent of total billed charges,68% of total billed charges,23.84,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18,20,,,percent of total billed charges,20% of total billed charges,18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.5,65,,,percent of total billed charges,65% of total billed charges,58.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18,61.2,
TUBE GASTROSTOMY 20F,3250529,CDM,272,RC,,,outpatient,,,157.9,78.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.58,20,,,percent of total billed charges,20% of total billed charges,31.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.58,20,,,percent of total billed charges,20% of total billed charges,31.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.64,65,,,percent of total billed charges,65% of total billed charges,102.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.58,102.64,
TUBE GASTROSTOMY 22FR,3250530,CDM,272,RC,,,outpatient,,,91.05,45.53,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.21,20,,,percent of total billed charges,20% of total billed charges,18.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.21,20,,,percent of total billed charges,20% of total billed charges,18.21,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.18,65,,,percent of total billed charges,65% of total billed charges,59.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,54.63,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.21,59.18,
TUBE SALEM SUMP 16F,3250615,CDM,272,RC,,,outpatient,,,57.25,28.63,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.45,20,,,percent of total billed charges,20% of total billed charges,11.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.45,20,,,percent of total billed charges,20% of total billed charges,11.45,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.21,65,,,percent of total billed charges,65% of total billed charges,37.21,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.35,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.45,53.67,
TUBE SALEM SUMP 18FR,3250493,CDM,272,RC,,,outpatient,,,11.35,5.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.27,20,,,percent of total billed charges,20% of total billed charges,2.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.27,20,,,percent of total billed charges,20% of total billed charges,2.27,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.38,65,,,percent of total billed charges,65% of total billed charges,7.38,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.81,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.27,53.67,
TUBE STOMACH 12FR,3250391,CDM,272,RC,,,outpatient,,,12.2,6.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.44,20,,,percent of total billed charges,20% of total billed charges,2.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.44,20,,,percent of total billed charges,20% of total billed charges,2.44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.93,65,,,percent of total billed charges,65% of total billed charges,7.93,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.32,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.44,53.67,
TUBE STOMACH 14FR,3250491,CDM,272,RC,,,outpatient,,,14.95,7.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.99,20,,,percent of total billed charges,20% of total billed charges,2.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.99,20,,,percent of total billed charges,20% of total billed charges,2.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,65,,,percent of total billed charges,65% of total billed charges,9.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.99,53.67,
TUBE STOMACH 16FR,3250347,CDM,272,RC,,,outpatient,,,14.95,7.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.99,20,,,percent of total billed charges,20% of total billed charges,2.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.99,20,,,percent of total billed charges,20% of total billed charges,2.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.72,65,,,percent of total billed charges,65% of total billed charges,9.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.99,53.67,
TUBE STOMACH PED 8FR,3250390,CDM,272,RC,,,outpatient,,,185.68,92.84,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.14,20,,,percent of total billed charges,20% of total billed charges,37.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.14,20,,,percent of total billed charges,20% of total billed charges,37.14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120.69,65,,,percent of total billed charges,65% of total billed charges,120.69,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,111.41,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37.14,120.69,
TUBE SUMP PEDIATRIC 10 FR,3250616,CDM,272,RC,,,outpatient,,,109.1,54.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.82,20,,,percent of total billed charges,20% of total billed charges,21.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.82,20,,,percent of total billed charges,20% of total billed charges,21.82,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70.92,65,,,percent of total billed charges,65% of total billed charges,70.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,65.46,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.82,70.92,
TUBERCULIN PPD INJ [5 TU/,3500826,CDM,636,RC,J3490,HCPCS,outpatient,,,46.15,23.08,,,,,,other,Not reimbursable per contract ,31.38,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.23,20,,,percent of total billed charges,20% of total billed charges,9.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.23,20,,,percent of total billed charges,20% of total billed charges,9.23,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36.92,80,,,case rate,80% for high cost drug carve out,39.23,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.69,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.23,39.23,
TUCKS MEDICATED COOLING PADS,3501144,CDM,250,RC,,,outpatient,,,18.85,9.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.77,20,,,percent of total billed charges,20% of total billed charges,3.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.77,20,,,percent of total billed charges,20% of total billed charges,3.77,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.25,65,,,percent of total billed charges,65% of total billed charges,12.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.31,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.77,53.67,
TUMS,3501091,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
U/S PREG TRANS VAG,3440367,CDM,972,RC,76817,HCPCS,outpatient,,,158.4,79.2,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,53.96,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,100.39,110,,,fee schedule,110% of Medicare physician fee schedule,100.39,110,,,fee schedule,110% of Medicare physician fee schedule,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,281.35,115,,,fee schedule,115% of Medicare physician fee schedule,106.56,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.96,100,,,fee schedule,100% of FL Medicaid fee schedule ,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,115.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.96,281.35,
UGI W AIR W KUB,3400203,CDM,320,RC,74247,HCPCS,outpatient,,,504,252,,327.6,65,,,percent of total billed charges,65% of total billed charges,342.72,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges,100.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges,100.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,327.6,65,,,percent of total billed charges,65% of total billed charges,327.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,342.72,
UGI W AIR W KUB,3440463,CDM,972,RC,74247,HCPCS,outpatient,,,125,62.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,176.4,100,,,case rate,100% of case rate fee,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,176.4,
UGI W KUB,3400201,CDM,320,RC,74240,HCPCS,outpatient,,,504,252,,327.6,65,,,percent of total billed charges,65% of total billed charges,342.72,68,,,percent of total billed charges,68% of total billed charges,48.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges,100.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges,100.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,327.6,65,,,percent of total billed charges,65% of total billed charges,327.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48.73,342.72,
UGI W KUB,3440465,CDM,972,RC,74240,HCPCS,outpatient,,,125,62.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,61.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,133.78,110,,,fee schedule,110% of Medicare physician fee schedule,133.78,110,,,fee schedule,110% of Medicare physician fee schedule,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,316.26,115,,,fee schedule,115% of Medicare physician fee schedule,114.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,153.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,61.71,316.26,
UGI W SM BOWEL,3400202,CDM,320,RC,74245,HCPCS,outpatient,,,173.73,86.87,,112.92,65,,,percent of total billed charges,65% of total billed charges,118.14,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.75,20,,,percent of total billed charges,20% of total billed charges,34.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.75,20,,,percent of total billed charges,20% of total billed charges,34.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,112.92,65,,,percent of total billed charges,65% of total billed charges,112.92,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,104.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.75,180,
UGI W SM BOWEL,3440467,CDM,972,RC,74245,HCPCS,outpatient,,,143,71.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,176.4,100,,,case rate,100% of case rate fee,52.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,,,,,other,Not seperately reimbursable,52.6,176.4,
ULT-PG UTER>14WKS SN,3400148,CDM,402,RC,76805,HCPCS,outpatient,,,295,147.5,,191.75,65,,,percent of total billed charges,65% of total billed charges,200.6,68,,,percent of total billed charges,68% of total billed charges,70.13,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59,20,,,percent of total billed charges,20% of total billed charges,59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59,20,,,percent of total billed charges,20% of total billed charges,59,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,191.75,65,,,percent of total billed charges,65% of total billed charges,191.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,177,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,200.6,
ULT/LOW EXTR ART BIL,3400183,CDM,921,RC,93925,HCPCS,outpatient,,,975,487.5,,633.75,65,,,percent of total billed charges,65% of total billed charges,663,68,,,percent of total billed charges,68% of total billed charges,133.25,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,20,,,percent of total billed charges,20% of total billed charges,195,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,20,,,percent of total billed charges,20% of total billed charges,195,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,633.75,65,,,percent of total billed charges,65% of total billed charges,633.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,663,
ULT/LOW EXTR ART BIL,3440271,CDM,972,RC,93925,HCPCS,outpatient,,,198,99,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,174.95,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,217.8,110,,,fee schedule,110% of Medicare physician fee schedule,217.8,110,,,fee schedule,110% of Medicare physician fee schedule,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,227.7,115,,,fee schedule,115% of Medicare physician fee schedule,227.55,100,,,fee schedule,100% of FL Medicaid fee schedule ,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,174.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,250.47,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,174.95,250.47,
ULT/LOW EXTR ART L,3440273,CDM,972,RC,93926,HCPCS,outpatient,,,115.5,57.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,103.43,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.05,110,,,fee schedule,110% of Medicare physician fee schedule,127.05,110,,,fee schedule,110% of Medicare physician fee schedule,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.83,115,,,fee schedule,115% of Medicare physician fee schedule,156.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,103.43,156.03,
ULT/LOW EXTR ART LT,3400178,CDM,921,RC,93926,HCPCS,outpatient,,,384,192,,249.6,65,,,percent of total billed charges,65% of total billed charges,261.12,68,,,percent of total billed charges,68% of total billed charges,88.99,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.8,20,,,percent of total billed charges,20% of total billed charges,76.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,76.8,20,,,percent of total billed charges,20% of total billed charges,76.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,249.6,65,,,percent of total billed charges,65% of total billed charges,249.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,230.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,261.12,
ULT/LOW EXTR ART R,3400182,CDM,921,RC,93926,HCPCS,outpatient,,,422.4,211.2,,274.56,65,,,percent of total billed charges,65% of total billed charges,287.23,68,,,percent of total billed charges,68% of total billed charges,88.99,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.48,20,,,percent of total billed charges,20% of total billed charges,84.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.48,20,,,percent of total billed charges,20% of total billed charges,84.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,274.56,65,,,percent of total billed charges,65% of total billed charges,274.56,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,287.23,
ULT/LOW EXTR ART R,3440275,CDM,972,RC,93926,HCPCS,outpatient,,,115.5,57.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,103.43,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.05,110,,,fee schedule,110% of Medicare physician fee schedule,127.05,110,,,fee schedule,110% of Medicare physician fee schedule,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,132.83,115,,,fee schedule,115% of Medicare physician fee schedule,156.03,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,103.43,156.03,
ULT/UPP  EXTR ART R,3440269,CDM,972,RC,93931,HCPCS,outpatient,,,85,42.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.5,110,,,fee schedule,110% of Medicare physician fee schedule,93.5,110,,,fee schedule,110% of Medicare physician fee schedule,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,97.75,115,,,fee schedule,115% of Medicare physician fee schedule,137.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85,137.6,
ULT/UPP EXTR ART BIL,3400187,CDM,921,RC,93930,HCPCS,outpatient,,,771,385.5,,501.15,65,,,percent of total billed charges,65% of total billed charges,524.28,68,,,percent of total billed charges,68% of total billed charges,141.23,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,154.2,20,,,percent of total billed charges,20% of total billed charges,154.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,154.2,20,,,percent of total billed charges,20% of total billed charges,154.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,501.15,65,,,percent of total billed charges,65% of total billed charges,501.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,462.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,524.28,
ULT/UPP EXTR ART BIL,3440265,CDM,972,RC,93930,HCPCS,outpatient,,,178.2,89.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,141.83,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,196.02,110,,,fee schedule,110% of Medicare physician fee schedule,196.02,110,,,fee schedule,110% of Medicare physician fee schedule,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,204.93,115,,,fee schedule,115% of Medicare physician fee schedule,194.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,141.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,225.42,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,141.83,225.42,
ULT/UPP EXTR ART L,3400181,CDM,921,RC,93931,HCPCS,outpatient,,,318,159,,206.7,65,,,percent of total billed charges,65% of total billed charges,216.24,68,,,percent of total billed charges,68% of total billed charges,93,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,20,,,percent of total billed charges,20% of total billed charges,63.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,20,,,percent of total billed charges,20% of total billed charges,63.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,206.7,65,,,percent of total billed charges,65% of total billed charges,206.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,216.24,
ULT/UPP EXTR ART L,3440267,CDM,972,RC,93931,HCPCS,outpatient,,,85,42.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,93.5,110,,,fee schedule,110% of Medicare physician fee schedule,93.5,110,,,fee schedule,110% of Medicare physician fee schedule,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,97.75,115,,,fee schedule,115% of Medicare physician fee schedule,137.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,85,100,,,fee schedule,100% of FL Medicaid fee schedule ,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,107.53,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85,137.6,
ULT/UPP EXTR ART-R,3400185,CDM,921,RC,93931,HCPCS,outpatient,,,318,159,,206.7,65,,,percent of total billed charges,65% of total billed charges,216.24,68,,,percent of total billed charges,68% of total billed charges,93,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,20,,,percent of total billed charges,20% of total billed charges,63.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.6,20,,,percent of total billed charges,20% of total billed charges,63.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,206.7,65,,,percent of total billed charges,65% of total billed charges,206.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,216.24,
ULTR PREG UTERUS LTD,3400149,CDM,402,RC,76815,HCPCS,outpatient,,,245,122.5,,159.25,65,,,percent of total billed charges,65% of total billed charges,166.6,68,,,percent of total billed charges,68% of total billed charges,47.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49,20,,,percent of total billed charges,20% of total billed charges,49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49,20,,,percent of total billed charges,20% of total billed charges,49,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.25,65,,,percent of total billed charges,65% of total billed charges,159.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,147,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.45,180,
ULTR TRANSVAG NON PG,3400155,CDM,402,RC,76830,HCPCS,outpatient,,,300,150,,195,65,,,percent of total billed charges,65% of total billed charges,204,68,,,percent of total billed charges,68% of total billed charges,51.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,65,,,percent of total billed charges,65% of total billed charges,195,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.12,204,
ULTRA ABDOMINAL COMP,3440231,CDM,972,RC,76700,HCPCS,outpatient,,,204.6,102.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.54,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.75,110,,,fee schedule,110% of Medicare physician fee schedule,125.75,110,,,fee schedule,110% of Medicare physician fee schedule,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,307.87,115,,,fee schedule,115% of Medicare physician fee schedule,120.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,144.61,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.54,307.87,
ULTRA AORTA,3400143,CDM,402,RC,76706,HCPCS,outpatient,,,435,217.5,,282.75,65,,,percent of total billed charges,65% of total billed charges,295.8,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,20,,,percent of total billed charges,20% of total billed charges,87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87,20,,,percent of total billed charges,20% of total billed charges,87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,282.75,65,,,percent of total billed charges,65% of total billed charges,282.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,295.8,
ULTRA AORTA,3440225,CDM,972,RC,76706,HCPCS,outpatient,,,169.4,84.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.16,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,114.65,110,,,fee schedule,110% of Medicare physician fee schedule,114.65,110,,,fee schedule,110% of Medicare physician fee schedule,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,296.26,115,,,fee schedule,115% of Medicare physician fee schedule,107.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.16,296.26,
ULTRA BREAST BIL,3440253,CDM,972,RC,76641,HCPCS,outpatient,,,306.9,153.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.55,110,,,fee schedule,110% of Medicare physician fee schedule,111.55,110,,,fee schedule,110% of Medicare physician fee schedule,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,293.02,115,,,fee schedule,115% of Medicare physician fee schedule,110.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,58.16,293.02,
ULTRA BREAST L,3440255,CDM,972,RC,76641,HCPCS,outpatient,,,159.5,79.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.55,110,,,fee schedule,110% of Medicare physician fee schedule,111.55,110,,,fee schedule,110% of Medicare physician fee schedule,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,293.02,115,,,fee schedule,115% of Medicare physician fee schedule,110.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,58.16,293.02,
ULTRA BREAST R,3440257,CDM,972,RC,76641,HCPCS,outpatient,,,159.5,79.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,111.55,110,,,fee schedule,110% of Medicare physician fee schedule,111.55,110,,,fee schedule,110% of Medicare physician fee schedule,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,293.02,115,,,fee schedule,115% of Medicare physician fee schedule,110.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,58.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,128.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,58.16,293.02,
ULTRA CAROTID BILAT,3440233,CDM,972,RC,93880,HCPCS,outpatient,,,207.9,103.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.22,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,204.66,110,,,fee schedule,110% of Medicare physician fee schedule,204.66,110,,,fee schedule,110% of Medicare physician fee schedule,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,213.96,115,,,fee schedule,115% of Medicare physician fee schedule,190.82,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,138.22,100,,,fee schedule,100% of FL Medicaid fee schedule ,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,235.35,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,138.22,235.35,
ULTRA CHEST B-SCAN,3400163,CDM,402,RC,76604,HCPCS,outpatient,,,328,164,,213.2,65,,,percent of total billed charges,65% of total billed charges,223.04,68,,,percent of total billed charges,68% of total billed charges,43.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.6,20,,,percent of total billed charges,20% of total billed charges,65.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.6,20,,,percent of total billed charges,20% of total billed charges,65.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,213.2,65,,,percent of total billed charges,65% of total billed charges,213.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,196.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.45,223.04,
ULTRA DOPPER AORTA,3440229,CDM,972,RC,93978,HCPCS,outpatient,,,120,60,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,120,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,132,110,,,fee schedule,110% of Medicare physician fee schedule,132,110,,,fee schedule,110% of Medicare physician fee schedule,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,138,115,,,fee schedule,115% of Medicare physician fee schedule,172.6,100,,,fee schedule,100% of FL Medicaid fee schedule ,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,120,100,,,fee schedule,100% of FL Medicaid fee schedule ,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,151.8,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,120,172.6,
ULTRA DOPPLER AORTA,3400180,CDM,921,RC,93978,HCPCS,outpatient,,,416,208,,270.4,65,,,percent of total billed charges,65% of total billed charges,282.88,68,,,percent of total billed charges,68% of total billed charges,137.4,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.2,20,,,percent of total billed charges,20% of total billed charges,83.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.2,20,,,percent of total billed charges,20% of total billed charges,83.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,270.4,65,,,percent of total billed charges,65% of total billed charges,270.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,249.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,282.88,
ULTRA ECHOCARDIOGRAM-PROFEE,3440316,CDM,972,RC,93307,HCPCS,outpatient,,,580,290,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,99.33,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.51,110,,,fee schedule,110% of Medicare physician fee schedule,146.51,110,,,fee schedule,110% of Medicare physician fee schedule,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,153.17,115,,,fee schedule,115% of Medicare physician fee schedule,151.93,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,99.33,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.49,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,99.33,168.49,
ULTRA EXTRE NON VASC,3400157,CDM,402,RC,76881,HCPCS,outpatient,,,360.8,180.4,,234.52,65,,,percent of total billed charges,65% of total billed charges,245.34,68,,,percent of total billed charges,68% of total billed charges,47.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.16,20,,,percent of total billed charges,20% of total billed charges,72.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72.16,20,,,percent of total billed charges,20% of total billed charges,72.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,234.52,65,,,percent of total billed charges,65% of total billed charges,234.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.45,245.34,
ULTRA NON VAS EXT,3440227,CDM,972,RC,76881,HCPCS,outpatient,,,140,70,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,56.23,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,59.38,110,,,fee schedule,110% of Medicare physician fee schedule,59.38,110,,,fee schedule,110% of Medicare physician fee schedule,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,238.48,115,,,fee schedule,115% of Medicare physician fee schedule,108.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.23,238.48,
ULTRA PELVIC NON OB,3440239,CDM,972,RC,76856,HCPCS,outpatient,,,146.3,73.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,60.94,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.92,110,,,fee schedule,110% of Medicare physician fee schedule,113.92,110,,,fee schedule,110% of Medicare physician fee schedule,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,295.49,115,,,fee schedule,115% of Medicare physician fee schedule,113.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.94,100,,,fee schedule,100% of FL Medicaid fee schedule ,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,131,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.94,295.49,
ULTRA PREG UTER LTD,3440235,CDM,972,RC,76815,HCPCS,outpatient,,,116.6,58.3,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.97,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,88.24,110,,,fee schedule,110% of Medicare physician fee schedule,88.24,110,,,fee schedule,110% of Medicare physician fee schedule,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,268.65,115,,,fee schedule,115% of Medicare physician fee schedule,99.57,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.97,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.48,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,46.97,268.65,
ULTRA RENAL BIL,3400158,CDM,402,RC,76770,HCPCS,outpatient,,,850,425,,552.5,65,,,percent of total billed charges,65% of total billed charges,578,68,,,percent of total billed charges,68% of total billed charges,65.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170,20,,,percent of total billed charges,20% of total billed charges,170,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170,20,,,percent of total billed charges,20% of total billed charges,170,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,552.5,65,,,percent of total billed charges,65% of total billed charges,552.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,510,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,578,
ULTRA RENAL BIL pro fee,3440259,CDM,972,RC,76770,HCPCS,outpatient,,,326.7,163.35,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,62.49,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,117.18,110,,,fee schedule,110% of Medicare physician fee schedule,117.18,110,,,fee schedule,110% of Medicare physician fee schedule,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,298.91,115,,,fee schedule,115% of Medicare physician fee schedule,115.09,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,62.49,100,,,fee schedule,100% of FL Medicaid fee schedule ,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,134.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,62.49,298.91,
ULTRA RENAL L,3440261,CDM,972,RC,76775,HCPCS,outpatient,,,154,77,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.26,110,,,fee schedule,110% of Medicare physician fee schedule,64.26,110,,,fee schedule,110% of Medicare physician fee schedule,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,243.58,115,,,fee schedule,115% of Medicare physician fee schedule,89.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.28,243.58,
ULTRA RENAL R,3440263,CDM,972,RC,76775,HCPCS,outpatient,,,154,77,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.28,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.26,110,,,fee schedule,110% of Medicare physician fee schedule,64.26,110,,,fee schedule,110% of Medicare physician fee schedule,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,243.58,115,,,fee schedule,115% of Medicare physician fee schedule,89.88,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,37.28,100,,,fee schedule,100% of FL Medicaid fee schedule ,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,73.9,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,37.28,243.58,
ULTRA SCROTUM,3440243,CDM,972,RC,76870,HCPCS,outpatient,,,151.8,75.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,42.64,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,108.9,110,,,fee schedule,110% of Medicare physician fee schedule,108.9,110,,,fee schedule,110% of Medicare physician fee schedule,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.85,115,,,fee schedule,115% of Medicare physician fee schedule,95.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,125.24,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,42.64,125.24,
ULTRA TRNVAG NON PG,3440251,CDM,972,RC,76830,HCPCS,outpatient,,,159.5,79.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.54,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,128.99,110,,,fee schedule,110% of Medicare physician fee schedule,128.99,110,,,fee schedule,110% of Medicare physician fee schedule,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,311.25,115,,,fee schedule,115% of Medicare physician fee schedule,120.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,67.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,148.33,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,67.54,311.25,
ULTRA VENOUS EXT-L,3400176,CDM,921,RC,93971,HCPCS,outpatient,,,975,487.5,,633.75,65,,,percent of total billed charges,65% of total billed charges,663,68,,,percent of total billed charges,68% of total billed charges,98.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,20,,,percent of total billed charges,20% of total billed charges,195,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,20,,,percent of total billed charges,20% of total billed charges,195,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,633.75,65,,,percent of total billed charges,65% of total billed charges,633.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,663,
ULTRA VENOUS L EXTREM,3440279,CDM,972,RC,93971,HCPCS,outpatient,,,108.9,54.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.64,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.79,110,,,fee schedule,110% of Medicare physician fee schedule,119.79,110,,,fee schedule,110% of Medicare physician fee schedule,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.24,115,,,fee schedule,115% of Medicare physician fee schedule,138.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85.64,138.24,
ULTRA VENUS BIL,3440277,CDM,972,RC,93970,HCPCS,outpatient,,,353.1,176.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,135.83,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,201.43,110,,,fee schedule,110% of Medicare physician fee schedule,201.43,110,,,fee schedule,110% of Medicare physician fee schedule,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,210.59,115,,,fee schedule,115% of Medicare physician fee schedule,188.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,135.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,231.65,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,135.83,231.65,
ULTRA VENUS R EXTREM,3440281,CDM,972,RC,93971,HCPCS,outpatient,,,108.9,54.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.64,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.79,110,,,fee schedule,110% of Medicare physician fee schedule,119.79,110,,,fee schedule,110% of Medicare physician fee schedule,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,125.24,115,,,fee schedule,115% of Medicare physician fee schedule,138.24,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,85.64,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,85.64,138.24,
ULTRA-ABDOMINAL COMP,3400156,CDM,402,RC,76700,HCPCS,outpatient,,,247.5,123.75,,160.88,65,,,percent of total billed charges,65% of total billed charges,168.3,68,,,percent of total billed charges,68% of total billed charges,65.82,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,20,,,percent of total billed charges,20% of total billed charges,49.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.5,20,,,percent of total billed charges,20% of total billed charges,49.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.88,65,,,percent of total billed charges,65% of total billed charges,160.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,148.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,49.5,180,
ULTRA-CAROTID BILAT,3400177,CDM,921,RC,93880,HCPCS,outpatient,,,1500,750,,975,65,,,percent of total billed charges,65% of total billed charges,1020,68,,,percent of total billed charges,68% of total billed charges,132.61,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,975,65,,,percent of total billed charges,65% of total billed charges,975,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1020,
ULTRA-ECHOCARDIOGRAM,3400172,CDM,480,RC,93307,HCPCS,outpatient,,,1800,900,,1170,65,,,percent of total billed charges,65% of total billed charges,1224,68,,,percent of total billed charges,68% of total billed charges,130.53,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,360,20,,,percent of total billed charges,20% of total billed charges,360,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,360,20,,,percent of total billed charges,20% of total billed charges,360,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1170,65,,,percent of total billed charges,65% of total billed charges,1170,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,591,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1080,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1224,
ULTRA-PELVIC NON OB,3400144,CDM,402,RC,76856,HCPCS,outpatient,,,350,175,,227.5,65,,,percent of total billed charges,65% of total billed charges,238,68,,,percent of total billed charges,68% of total billed charges,51.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70,20,,,percent of total billed charges,20% of total billed charges,70,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,70,20,,,percent of total billed charges,20% of total billed charges,70,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,227.5,65,,,percent of total billed charges,65% of total billed charges,227.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,210,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.12,238,
ULTRA-SCROTUM,3400147,CDM,402,RC,76870,HCPCS,outpatient,,,422,211,,274.3,65,,,percent of total billed charges,65% of total billed charges,286.96,68,,,percent of total billed charges,68% of total billed charges,51.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.4,20,,,percent of total billed charges,20% of total billed charges,84.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.4,20,,,percent of total billed charges,20% of total billed charges,84.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,274.3,65,,,percent of total billed charges,65% of total billed charges,274.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,253.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.12,286.96,
ULTRA/  AAA SCREEN,3400208,CDM,402,RC,76706,HCPCS,outpatient,,,98,49,,63.7,65,,,percent of total billed charges,65% of total billed charges,66.64,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.7,65,,,percent of total billed charges,65% of total billed charges,63.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.6,180,
ULTRA/BREAST-BIL,3400153,CDM,402,RC,76641,HCPCS,outpatient,,,500,250,,325,65,,,percent of total billed charges,65% of total billed charges,340,68,,,percent of total billed charges,68% of total billed charges,35.31,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,20,,,percent of total billed charges,20% of total billed charges,100,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100,20,,,percent of total billed charges,20% of total billed charges,100,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,325,65,,,percent of total billed charges,65% of total billed charges,325,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,300,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.31,340,
ULTRA/BREAST-L,3400150,CDM,402,RC,76641,HCPCS,outpatient,,,349,174.5,,226.85,65,,,percent of total billed charges,65% of total billed charges,237.32,68,,,percent of total billed charges,68% of total billed charges,35.31,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.8,20,,,percent of total billed charges,20% of total billed charges,69.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.8,20,,,percent of total billed charges,20% of total billed charges,69.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,226.85,65,,,percent of total billed charges,65% of total billed charges,226.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.31,237.32,
ULTRA/BREAST-R,3400152,CDM,402,RC,76641,HCPCS,outpatient,,,349,174.5,,226.85,65,,,percent of total billed charges,65% of total billed charges,237.32,68,,,percent of total billed charges,68% of total billed charges,35.31,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.8,20,,,percent of total billed charges,20% of total billed charges,69.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.8,20,,,percent of total billed charges,20% of total billed charges,69.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,226.85,65,,,percent of total billed charges,65% of total billed charges,226.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,209.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.31,237.32,
ULTRA/RENAL-L,3400142,CDM,402,RC,76775,HCPCS,outpatient,,,310,155,,201.5,65,,,percent of total billed charges,65% of total billed charges,210.8,68,,,percent of total billed charges,68% of total billed charges,47.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62,20,,,percent of total billed charges,20% of total billed charges,62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62,20,,,percent of total billed charges,20% of total billed charges,62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,201.5,65,,,percent of total billed charges,65% of total billed charges,201.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.45,210.8,
ULTRA/RENAL-R,3400154,CDM,402,RC,76775,HCPCS,outpatient,,,310,155,,201.5,65,,,percent of total billed charges,65% of total billed charges,210.8,68,,,percent of total billed charges,68% of total billed charges,47.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62,20,,,percent of total billed charges,20% of total billed charges,62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62,20,,,percent of total billed charges,20% of total billed charges,62,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,201.5,65,,,percent of total billed charges,65% of total billed charges,201.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,186,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.45,210.8,
ULTRA/VENOUS EXT-BIL,3400186,CDM,921,RC,93970,HCPCS,outpatient,,,1025,512.5,,666.25,65,,,percent of total billed charges,65% of total billed charges,697,68,,,percent of total billed charges,68% of total billed charges,147.62,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205,20,,,percent of total billed charges,20% of total billed charges,205,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,205,20,,,percent of total billed charges,20% of total billed charges,205,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,666.25,65,,,percent of total billed charges,65% of total billed charges,666.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,615,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,697,
ULTRA/VENOUS EXT-R,3400184,CDM,921,RC,93971,HCPCS,outpatient,,,975,487.5,,633.75,65,,,percent of total billed charges,65% of total billed charges,663,68,,,percent of total billed charges,68% of total billed charges,98.58,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,20,,,percent of total billed charges,20% of total billed charges,195,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,20,,,percent of total billed charges,20% of total billed charges,195,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,633.75,65,,,percent of total billed charges,65% of total billed charges,633.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,585,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,663,
ULTRASOUND CHEST,3440170,CDM,972,RC,76604,HCPCS,outpatient,,,140,70,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,48.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,61.83,110,,,fee schedule,110% of Medicare physician fee schedule,61.83,110,,,fee schedule,110% of Medicare physician fee schedule,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,241.04,115,,,fee schedule,115% of Medicare physician fee schedule,101.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,71.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.72,241.04,
ULTRASOUND/15M,3600011,CDM,420,RC,97035,HCPCS,outpatient,,,88,44,,57.2,65,,,percent of total billed charges,65% of total billed charges,59.84,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.6,20,,,percent of total billed charges,20% of total billed charges,17.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,57.2,65,,,percent of total billed charges,65% of total billed charges,57.2,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.6,82,
UNDERPADS DISP 5 PKG,3250077,CDM,271,RC,,,outpatient,,,5.9,2.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.18,20,,,percent of total billed charges,20% of total billed charges,1.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.18,20,,,percent of total billed charges,20% of total billed charges,1.18,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,65,,,percent of total billed charges,65% of total billed charges,3.84,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.54,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.18,53.67,
UNIV CLIP APPLIER,6215832,CDM,272,RC,,,outpatient,,,435.2,217.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.04,20,,,percent of total billed charges,20% of total billed charges,87.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,87.04,20,,,percent of total billed charges,20% of total billed charges,87.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,282.88,65,,,percent of total billed charges,65% of total billed charges,282.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,261.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,282.88,
UPPER GI SERIES,3400056,CDM,320,RC,74246,HCPCS,outpatient,,,504,252,,327.6,65,,,percent of total billed charges,65% of total billed charges,342.72,68,,,percent of total billed charges,68% of total billed charges,54.96,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges,100.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,100.8,20,,,percent of total billed charges,20% of total billed charges,100.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,327.6,65,,,percent of total billed charges,65% of total billed charges,327.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,302.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,342.72,
UPPER GI SERIES,3440283,CDM,972,RC,74246,HCPCS,outpatient,,,137.5,68.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,69.47,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,151.25,110,,,fee schedule,110% of Medicare physician fee schedule,151.25,110,,,fee schedule,110% of Medicare physician fee schedule,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,334.53,115,,,fee schedule,115% of Medicare physician fee schedule,122.07,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,69.47,100,,,fee schedule,100% of FL Medicaid fee schedule ,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,173.94,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,69.47,334.53,
URETHRAL DILITATIONS,3020027,CDM,360,RC,,,outpatient,,,280,140,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56,20,,,percent of total billed charges,20% of total billed charges,56,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,182,65,,,percent of total billed charges,65% of total billed charges,182,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,168,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,182,
URIC ACID 24HR OTH,3300209,CDM,301,RC,84560,HCPCS,outpatient,,,50,25,,32.5,65,,,percent of total billed charges,65% of total billed charges,34,68,,,percent of total billed charges,68% of total billed charges,6.74,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.74,34,
URIC ACID SERUM,3300073,CDM,301,RC,84550,HCPCS,outpatient,,,27.5,13.75,,17.88,65,,,percent of total billed charges,65% of total billed charges,18.7,68,,,percent of total billed charges,68% of total billed charges,6.41,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.5,20,,,percent of total billed charges,20% of total billed charges,5.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.5,20,,,percent of total billed charges,20% of total billed charges,5.5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.88,65,,,percent of total billed charges,65% of total billed charges,17.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.75,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.5,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.5,18.7,
URINALYSIS,3300771,CDM,301,RC,81001,HCPCS,outpatient,,,15,7.5,,9.75,65,,,percent of total billed charges,65% of total billed charges,10.2,68,,,percent of total billed charges,68% of total billed charges,4.49,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,20,,,percent of total billed charges,20% of total billed charges,3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.75,65,,,percent of total billed charges,65% of total billed charges,9.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,10.2,
URINALYSIS - MICRO ONLY,3300893,CDM,307,RC,81015,HCPCS,outpatient,,,4,2,,2.6,65,,,percent of total billed charges,65% of total billed charges,2.72,68,,,percent of total billed charges,68% of total billed charges,3.98,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.8,20,,,percent of total billed charges,20% of total billed charges,0.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.8,20,,,percent of total billed charges,20% of total billed charges,0.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.6,65,,,percent of total billed charges,65% of total billed charges,2.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.8,3.98,
URINARY DRAINAGE BAG,3250389,CDM,272,RC,,,outpatient,,,53.95,26.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.79,20,,,percent of total billed charges,20% of total billed charges,10.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.79,20,,,percent of total billed charges,20% of total billed charges,10.79,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.07,65,,,percent of total billed charges,65% of total billed charges,35.07,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.37,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.79,53.67,
URINARY LEG BAG,3250149,CDM,272,RC,,,outpatient,,,15.8,7.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.16,20,,,percent of total billed charges,20% of total billed charges,3.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.16,20,,,percent of total billed charges,20% of total billed charges,3.16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.27,65,,,percent of total billed charges,65% of total billed charges,10.27,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.16,53.67,
URINE 24 HR CALCIUM,3300245,CDM,301,RC,82340,HCPCS,outpatient,,,50,25,,32.5,65,,,percent of total billed charges,65% of total billed charges,34,68,,,percent of total billed charges,68% of total billed charges,8.57,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,20,,,percent of total billed charges,20% of total billed charges,10,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.5,65,,,percent of total billed charges,65% of total billed charges,32.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.57,34,
URINE ACETONE,3300773,CDM,307,RC,81000,HCPCS,outpatient,,,41,20.5,,26.65,65,,,percent of total billed charges,65% of total billed charges,27.88,68,,,percent of total billed charges,68% of total billed charges,4.49,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.2,20,,,percent of total billed charges,20% of total billed charges,8.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.65,65,,,percent of total billed charges,65% of total billed charges,26.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.49,27.88,
URINE AMYLASE,3300305,CDM,301,RC,82150,HCPCS,outpatient,,,51,25.5,,33.15,65,,,percent of total billed charges,65% of total billed charges,34.68,68,,,percent of total billed charges,68% of total billed charges,9.2,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.2,20,,,percent of total billed charges,20% of total billed charges,10.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.15,65,,,percent of total billed charges,65% of total billed charges,33.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.2,34.68,
URINE CHLORIDE,3300393,CDM,301,RC,82436,HCPCS,outpatient,,,37,18.5,,24.05,65,,,percent of total billed charges,65% of total billed charges,25.16,68,,,percent of total billed charges,68% of total billed charges,4.5,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.4,20,,,percent of total billed charges,20% of total billed charges,7.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.4,20,,,percent of total billed charges,20% of total billed charges,7.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.05,65,,,percent of total billed charges,65% of total billed charges,24.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.5,25.16,
URINE COL PEDIATRIC,3250393,CDM,272,RC,,,outpatient,,,8.3,4.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.66,20,,,percent of total billed charges,20% of total billed charges,1.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.66,20,,,percent of total billed charges,20% of total billed charges,1.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.4,65,,,percent of total billed charges,65% of total billed charges,5.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.98,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.66,53.67,
URINE CORTISOL 24 HR,3300257,CDM,301,RC,82533,HCPCS,outpatient,,,104,52,,67.6,65,,,percent of total billed charges,65% of total billed charges,70.72,68,,,percent of total billed charges,68% of total billed charges,23.14,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.8,20,,,percent of total billed charges,20% of total billed charges,20.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.8,20,,,percent of total billed charges,20% of total billed charges,20.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,67.6,65,,,percent of total billed charges,65% of total billed charges,67.6,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,62.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.8,70.72,
URINE CREATININE 24HR,3300313,CDM,301,RC,82570,HCPCS,outpatient,,,52,26,,33.8,65,,,percent of total billed charges,65% of total billed charges,35.36,68,,,percent of total billed charges,68% of total billed charges,7.34,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.34,35.36,
"Urine Culture, SO",3300899,CDM,306,RC,87086,HCPCS,outpatient,,,60,30,,39,65,,,percent of total billed charges,65% of total billed charges,40.8,68,,,percent of total billed charges,68% of total billed charges,11.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,20,,,percent of total billed charges,20% of total billed charges,12,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,65,,,percent of total billed charges,65% of total billed charges,39,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,36,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.46,40.8,
URINE CYTOLOGY,3300825,CDM,310,RC,88108,HCPCS,outpatient,,,107,53.5,,69.55,65,,,percent of total billed charges,65% of total billed charges,72.76,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.4,20,,,percent of total billed charges,20% of total billed charges,21.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.55,65,,,percent of total billed charges,65% of total billed charges,69.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,64.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,21.4,72.76,
URINE DIPSTICK ONLY,3300775,CDM,307,RC,81003,HCPCS,outpatient,,,16.5,8.25,,10.73,65,,,percent of total billed charges,65% of total billed charges,11.22,68,,,percent of total billed charges,68% of total billed charges,3.18,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.3,20,,,percent of total billed charges,20% of total billed charges,3.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.3,20,,,percent of total billed charges,20% of total billed charges,3.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.73,65,,,percent of total billed charges,65% of total billed charges,10.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.25,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.18,11.22,
URINE DRUG SCREEN,3300273,CDM,301,RC,80100,HCPCS,outpatient,,,69,34.5,,44.85,65,,,percent of total billed charges,65% of total billed charges,46.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,20,,,percent of total billed charges,20% of total billed charges,13.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,20,,,percent of total billed charges,20% of total billed charges,13.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44.85,65,,,percent of total billed charges,65% of total billed charges,44.85,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,46.92,
URINE MYOGLOBIN,3300336,CDM,301,RC,83874,HCPCS,outpatient,,,40,20,,26,65,,,percent of total billed charges,65% of total billed charges,27.2,68,,,percent of total billed charges,68% of total billed charges,18.32,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8,20,,,percent of total billed charges,20% of total billed charges,8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,65,,,percent of total billed charges,65% of total billed charges,26,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8,27.2,
URINE OSMOLALITY,3300283,CDM,301,RC,83935,HCPCS,outpatient,,,58,29,,37.7,65,,,percent of total billed charges,65% of total billed charges,39.44,68,,,percent of total billed charges,68% of total billed charges,9.67,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.6,20,,,percent of total billed charges,20% of total billed charges,11.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.6,20,,,percent of total billed charges,20% of total billed charges,11.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.7,65,,,percent of total billed charges,65% of total billed charges,37.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.67,39.44,
URINE POTASSIUM,3300315,CDM,301,RC,84133,HCPCS,outpatient,,,52,26,,33.8,65,,,percent of total billed charges,65% of total billed charges,35.36,68,,,percent of total billed charges,68% of total billed charges,6.1,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.1,35.36,
URINE PROTEIN 24HR,3300309,CDM,301,RC,84156,HCPCS,outpatient,,,52,26,,33.8,65,,,percent of total billed charges,65% of total billed charges,35.36,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.4,35.36,
URINE SODIUM,3300311,CDM,301,RC,84300,HCPCS,outpatient,,,52,26,,33.8,65,,,percent of total billed charges,65% of total billed charges,35.36,68,,,percent of total billed charges,68% of total billed charges,6.9,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.4,20,,,percent of total billed charges,20% of total billed charges,10.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.8,65,,,percent of total billed charges,65% of total billed charges,33.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.9,35.36,
URINE STRAINER,3250103,CDM,271,RC,,,outpatient,,,7.65,3.83,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.53,20,,,percent of total billed charges,20% of total billed charges,1.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.53,20,,,percent of total billed charges,20% of total billed charges,1.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.97,65,,,percent of total billed charges,65% of total billed charges,4.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.53,53.67,
US ABD DOPPLER+FLOW,3400188,CDM,921,RC,93975,HCPCS,outpatient,,,600,300,,390,65,,,percent of total billed charges,65% of total billed charges,408,68,,,percent of total billed charges,68% of total billed charges,167.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,20,,,percent of total billed charges,20% of total billed charges,120,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,20,,,percent of total billed charges,20% of total billed charges,120,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,390,65,,,percent of total billed charges,65% of total billed charges,390,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,360,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,408,
US ABD DOPPLER+FLOW,3440005,CDM,972,RC,93975,HCPCS,outpatient,,,231,115.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.99,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,254.1,110,,,fee schedule,110% of Medicare physician fee schedule,254.1,110,,,fee schedule,110% of Medicare physician fee schedule,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,265.65,115,,,fee schedule,115% of Medicare physician fee schedule,244.59,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,191.99,100,,,fee schedule,100% of FL Medicaid fee schedule ,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,292.22,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,191.99,292.22,
US ABD LIMITED,3400159,CDM,402,RC,76705,HCPCS,outpatient,,,368.5,184.25,,239.53,65,,,percent of total billed charges,65% of total billed charges,250.58,68,,,percent of total billed charges,68% of total billed charges,47.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.7,20,,,percent of total billed charges,20% of total billed charges,73.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,73.7,20,,,percent of total billed charges,20% of total billed charges,73.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,239.53,65,,,percent of total billed charges,65% of total billed charges,239.53,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,221.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.45,250.58,
US ABD LIMITED,3440245,CDM,972,RC,76705,HCPCS,outpatient,,,139.7,69.85,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,50.46,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,95.12,110,,,fee schedule,110% of Medicare physician fee schedule,95.12,110,,,fee schedule,110% of Medicare physician fee schedule,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,275.84,115,,,fee schedule,115% of Medicare physician fee schedule,103.06,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.46,100,,,fee schedule,100% of FL Medicaid fee schedule ,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,109.38,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.46,275.84,
US BLADDER ONLY POST VOID,3400302,CDM,402,RC,51798,HCPCS,outpatient,,,197.86,98.93,,128.61,65,,,percent of total billed charges,65% of total billed charges,134.54,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.57,20,,,percent of total billed charges,20% of total billed charges,39.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39.57,20,,,percent of total billed charges,20% of total billed charges,39.57,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,128.61,65,,,percent of total billed charges,65% of total billed charges,128.61,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,118.72,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39.57,178,
US BLADDER ONLY POST VOID PROFEE,3440488,CDM,972,RC,51798,HCPCS,outpatient,,,52,26,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,7.9,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.4,110,,,fee schedule,110% of Medicare physician fee schedule,11.4,110,,,fee schedule,110% of Medicare physician fee schedule,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,11.91,115,,,fee schedule,115% of Medicare physician fee schedule,60.5,100,,,fee schedule,100% of FL Medicaid fee schedule ,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,7.9,100,,,fee schedule,100% of FL Medicaid fee schedule ,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,13.11,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,7.9,60.5,
US EXAM AAA SCREEN,3440461,CDM,972,RC,76706,HCPCS,outpatient,,,97,48.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.16,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,106.7,110,,,fee schedule,110% of Medicare physician fee schedule,106.7,110,,,fee schedule,110% of Medicare physician fee schedule,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,287.95,115,,,fee schedule,115% of Medicare physician fee schedule,107.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,55.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,122.71,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,55.16,287.95,
US GUIDE/ASP/BX,3400162,CDM,402,RC,76942,HCPCS,outpatient,,,578,289,,375.7,65,,,percent of total billed charges,65% of total billed charges,393.04,68,,,percent of total billed charges,68% of total billed charges,51.12,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.6,20,,,percent of total billed charges,20% of total billed charges,115.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.6,20,,,percent of total billed charges,20% of total billed charges,115.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,375.7,65,,,percent of total billed charges,65% of total billed charges,375.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.12,393.04,
US GUIDE/ASP/BX,3440397,CDM,972,RC,76942,HCPCS,outpatient,,,130,65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.1,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,63.42,110,,,fee schedule,110% of Medicare physician fee schedule,63.42,110,,,fee schedule,110% of Medicare physician fee schedule,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,242.7,115,,,fee schedule,115% of Medicare physician fee schedule,122.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,70.1,100,,,fee schedule,100% of FL Medicaid fee schedule ,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,72.93,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,63.42,242.7,
US INFANT HIPS; DYNAMIC,3400222,CDM,402,RC,76886,HCPCS,outpatient,,,265,132.5,,172.25,65,,,percent of total billed charges,65% of total billed charges,180.2,68,,,percent of total billed charges,68% of total billed charges,51.38,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53,20,,,percent of total billed charges,20% of total billed charges,53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53,20,,,percent of total billed charges,20% of total billed charges,53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,172.25,65,,,percent of total billed charges,65% of total billed charges,172.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.38,180.2,
US INFANT HIPS; DYNAMIC,3440222,CDM,972,RC,76886,HCPCS,outpatient,,,90,45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.16,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,99,110,,,fee schedule,110% of Medicare physician fee schedule,99,110,,,fee schedule,110% of Medicare physician fee schedule,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,103.5,115,,,fee schedule,115% of Medicare physician fee schedule,103.76,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.16,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.85,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.16,113.85,
US NEONATAL HEAD,3400160,CDM,402,RC,76506,HCPCS,outpatient,,,158,79,,102.7,65,,,percent of total billed charges,65% of total billed charges,107.44,68,,,percent of total billed charges,68% of total billed charges,47.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.6,20,,,percent of total billed charges,20% of total billed charges,31.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.6,20,,,percent of total billed charges,20% of total billed charges,31.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,102.7,65,,,percent of total billed charges,65% of total billed charges,102.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,94.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.6,180,
US NEONATAL HEAD,3440391,CDM,972,RC,76506,HCPCS,outpatient,,,59,29.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,65.17,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.9,110,,,fee schedule,110% of Medicare physician fee schedule,64.9,110,,,fee schedule,110% of Medicare physician fee schedule,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,244.25,115,,,fee schedule,115% of Medicare physician fee schedule,117.77,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.17,100,,,fee schedule,100% of FL Medicaid fee schedule ,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,74.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.9,244.25,
US PELVIC LIMITED NON OB,3400303,CDM,402,RC,76857,HCPCS,outpatient,,,216.5,108.25,,140.73,65,,,percent of total billed charges,65% of total billed charges,147.22,68,,,percent of total billed charges,68% of total billed charges,35.31,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.3,20,,,percent of total billed charges,20% of total billed charges,43.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.3,20,,,percent of total billed charges,20% of total billed charges,43.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,140.73,65,,,percent of total billed charges,65% of total billed charges,140.73,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,129.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,35.31,180,
US PELVIC LIMITED NON OB,3440489,CDM,972,RC,76857,HCPCS,outpatient,,,73.5,36.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,32.7,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,52.84,110,,,fee schedule,110% of Medicare physician fee schedule,52.84,110,,,fee schedule,110% of Medicare physician fee schedule,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,231.65,115,,,fee schedule,115% of Medicare physician fee schedule,85.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,32.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,60.77,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,32.7,231.65,
US PG DETAIL EA ADDL,3400164,CDM,402,RC,76812,HCPCS,outpatient,,,417,208.5,,271.05,65,,,percent of total billed charges,65% of total billed charges,283.56,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,20,,,percent of total billed charges,20% of total billed charges,83.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,20,,,percent of total billed charges,20% of total billed charges,83.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,271.05,65,,,percent of total billed charges,65% of total billed charges,271.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,283.56,
US PG DETAIL EA ADDL,3440429,CDM,972,RC,76812,HCPCS,outpatient,,,165,82.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,113.92,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,181.5,110,,,fee schedule,110% of Medicare physician fee schedule,181.5,110,,,fee schedule,110% of Medicare physician fee schedule,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,366.15,115,,,fee schedule,115% of Medicare physician fee schedule,166.52,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,113.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,113.92,366.15,
US PG DETAIL SINGLE,3400165,CDM,402,RC,76811,HCPCS,outpatient,,,462,231,,300.3,65,,,percent of total billed charges,65% of total billed charges,314.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.4,20,,,percent of total billed charges,20% of total billed charges,92.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,92.4,20,,,percent of total billed charges,20% of total billed charges,92.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300.3,65,,,percent of total billed charges,65% of total billed charges,300.3,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,277.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,314.16,
US PG DETAIL SNG,3440431,CDM,972,RC,76811,HCPCS,outpatient,,,165,82.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,101.7,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,181.5,110,,,fee schedule,110% of Medicare physician fee schedule,181.5,110,,,fee schedule,110% of Medicare physician fee schedule,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,366.15,115,,,fee schedule,115% of Medicare physician fee schedule,154.3,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,101.7,100,,,fee schedule,100% of FL Medicaid fee schedule ,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,208.73,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,101.7,366.15,
US PG UTER<14 WK SNG,3440435,CDM,972,RC,76801,HCPCS,outpatient,,,181.5,90.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.32,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,127.2,110,,,fee schedule,110% of Medicare physician fee schedule,127.2,110,,,fee schedule,110% of Medicare physician fee schedule,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,309.39,115,,,fee schedule,115% of Medicare physician fee schedule,120.92,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,68.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,146.28,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,68.32,309.39,
US PG UTER<14WK EA ADD,3400166,CDM,402,RC,76802,HCPCS,outpatient,,,417,208.5,,271.05,65,,,percent of total billed charges,65% of total billed charges,283.56,68,,,percent of total billed charges,68% of total billed charges,70.13,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,20,,,percent of total billed charges,20% of total billed charges,83.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,20,,,percent of total billed charges,20% of total billed charges,83.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,271.05,65,,,percent of total billed charges,65% of total billed charges,271.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,283.56,
US PG UTER<14WK EA ADD,3440433,CDM,972,RC,76802,HCPCS,outpatient,,,165,82.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,35.72,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,66.74,110,,,fee schedule,110% of Medicare physician fee schedule,66.74,110,,,fee schedule,110% of Medicare physician fee schedule,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,246.17,115,,,fee schedule,115% of Medicare physician fee schedule,88.32,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,35.72,100,,,fee schedule,100% of FL Medicaid fee schedule ,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,76.75,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,35.72,246.17,
US PG UTER>14WKS SN,3440241,CDM,972,RC,76805,HCPCS,outpatient,,,181.5,90.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.79,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,146.31,110,,,fee schedule,110% of Medicare physician fee schedule,146.31,110,,,fee schedule,110% of Medicare physician fee schedule,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,329.36,115,,,fee schedule,115% of Medicare physician fee schedule,131.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,78.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,168.26,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,78.79,329.36,
US PG UTR<14WKS SING,3400167,CDM,402,RC,76801,HCPCS,outpatient,,,417,208.5,,271.05,65,,,percent of total billed charges,65% of total billed charges,283.56,68,,,percent of total billed charges,68% of total billed charges,70.13,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,20,,,percent of total billed charges,20% of total billed charges,83.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,20,,,percent of total billed charges,20% of total billed charges,83.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,271.05,65,,,percent of total billed charges,65% of total billed charges,271.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,283.56,
US PG UTR>14WK EA AD,3400168,CDM,402,RC,76810,HCPCS,outpatient,,,417,208.5,,271.05,65,,,percent of total billed charges,65% of total billed charges,283.56,68,,,percent of total billed charges,68% of total billed charges,70.13,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,20,,,percent of total billed charges,20% of total billed charges,83.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,83.4,20,,,percent of total billed charges,20% of total billed charges,83.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,271.05,65,,,percent of total billed charges,65% of total billed charges,271.05,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,250.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,283.56,
US PG UTR>14WK EA ADD,3440437,CDM,972,RC,76810,HCPCS,outpatient,,,165,82.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.63,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,96,110,,,fee schedule,110% of Medicare physician fee schedule,96,110,,,fee schedule,110% of Medicare physician fee schedule,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,276.76,115,,,fee schedule,115% of Medicare physician fee schedule,104.23,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.63,100,,,fee schedule,100% of FL Medicaid fee schedule ,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,110.4,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,51.63,276.76,
US PREG TRANS VAG,3400161,CDM,402,RC,76817,HCPCS,outpatient,,,412,206,,267.8,65,,,percent of total billed charges,65% of total billed charges,280.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.4,20,,,percent of total billed charges,20% of total billed charges,82.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.4,20,,,percent of total billed charges,20% of total billed charges,82.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,267.8,65,,,percent of total billed charges,65% of total billed charges,267.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,247.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,280.16,
US SOFT TISSUE HEAD & NECK,3400169,CDM,402,RC,76536,HCPCS,outpatient,,,345.4,172.7,,224.51,65,,,percent of total billed charges,65% of total billed charges,234.87,68,,,percent of total billed charges,68% of total billed charges,47.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.08,20,,,percent of total billed charges,20% of total billed charges,69.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.08,20,,,percent of total billed charges,20% of total billed charges,69.08,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,224.51,65,,,percent of total billed charges,65% of total billed charges,224.51,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,207.24,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,47.45,234.87,
US SOFT TISSUE HEAD & NECK,3440247,CDM,972,RC,76536,HCPCS,outpatient,,,152.9,76.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.25,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,119.58,110,,,fee schedule,110% of Medicare physician fee schedule,119.58,110,,,fee schedule,110% of Medicare physician fee schedule,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,301.42,115,,,fee schedule,115% of Medicare physician fee schedule,116.85,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,64.25,100,,,fee schedule,100% of FL Medicaid fee schedule ,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,137.52,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,64.25,301.42,
US VASC  NEEDLE GUIDE,3400301,CDM,402,RC,76937,HCPCS,outpatient,,,578,289,,375.7,65,,,percent of total billed charges,65% of total billed charges,393.04,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.6,20,,,percent of total billed charges,20% of total billed charges,115.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.6,20,,,percent of total billed charges,20% of total billed charges,115.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,375.7,65,,,percent of total billed charges,65% of total billed charges,375.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,346.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,393.04,
US VASC NEEDLE GUIDE PRO FEE,3440487,CDM,972,RC,76937,HCPCS,outpatient,,,130,65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.78,110,,,fee schedule,110% of Medicare physician fee schedule,42.78,110,,,fee schedule,110% of Medicare physician fee schedule,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,221.12,115,,,fee schedule,115% of Medicare physician fee schedule,69.87,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,17.27,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,49.2,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,17.27,221.12,
US XTR NON-VASC LMTD,3400207,CDM,402,RC,76882,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,47.45,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,180,
US XTR NON-VASC LMTD,3440479,CDM,972,RC,76882,HCPCS,outpatient,,,64,32,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.79,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,46.64,110,,,fee schedule,110% of Medicare physician fee schedule,46.64,110,,,fee schedule,110% of Medicare physician fee schedule,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.16,115,,,fee schedule,115% of Medicare physician fee schedule,72.39,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.79,100,,,fee schedule,100% of FL Medicaid fee schedule ,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,53.64,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.79,225.16,
"UVC 3.5 FR 15"" DUAL",3250064,CDM,272,RC,,,outpatient,,,192.65,96.33,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.53,20,,,percent of total billed charges,20% of total billed charges,38.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.53,20,,,percent of total billed charges,20% of total billed charges,38.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,125.22,65,,,percent of total billed charges,65% of total billed charges,125.22,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,115.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,38.53,125.22,
UVC TRAY,3521987,CDM,272,RC,,,outpatient,,,266.9,133.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.38,20,,,percent of total billed charges,20% of total billed charges,53.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.38,20,,,percent of total billed charges,20% of total billed charges,53.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,173.49,65,,,percent of total billed charges,65% of total billed charges,173.49,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,160.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.38,173.49,
VAC- HEPATITIS B INJ [20,3500827,CDM,636,RC,G0008,HCPCS,outpatient,,,298.4,149.2,,193.96,65,,,percent of total billed charges,65% of total billed charges,202.91,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.68,20,,,percent of total billed charges,20% of total billed charges,59.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,59.68,20,,,percent of total billed charges,20% of total billed charges,59.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,238.72,80,,,case rate,80% for high cost drug carve out,253.64,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,179.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,59.68,253.64,
VAC- INFLUENZA VIRUS INJ,3500828,CDM,636,RC,G0008,HCPCS,outpatient,,,68.35,34.18,,44.43,65,,,percent of total billed charges,65% of total billed charges,46.48,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.67,20,,,percent of total billed charges,20% of total billed charges,13.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.67,20,,,percent of total billed charges,20% of total billed charges,13.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,54.68,80,,,case rate,80% for high cost drug carve out,58.1,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,41.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.67,58.1,
VAC- PNEUMOCOCCAL 23 INJ,3500829,CDM,636,RC,G0008,HCPCS,outpatient,,,226.85,113.43,,147.45,65,,,percent of total billed charges,65% of total billed charges,154.26,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.37,20,,,percent of total billed charges,20% of total billed charges,45.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.37,20,,,percent of total billed charges,20% of total billed charges,45.37,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,181.48,80,,,case rate,80% for high cost drug carve out,192.82,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,136.11,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.37,192.82,
VAC- TETANUS DIPH TOX ADU,3500831,CDM,636,RC,J1670,HCPCS,outpatient,,,165.85,82.93,,,,,,other,Not reimbursable per contract ,112.78,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.17,20,,,percent of total billed charges,20% of total billed charges,33.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.17,20,,,percent of total billed charges,20% of total billed charges,33.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132.68,80,,,case rate,80% for high cost drug carve out,140.97,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,99.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.17,140.97,
VAGINAL DELIVERY,3231131,CDM,450,RC,59409,HCPCS,outpatient,,,2094,1047,,1361.1,65,,,percent of total billed charges,65% of total billed charges,1423.92,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,418.8,20,,,percent of total billed charges,20% of total billed charges,418.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,418.8,20,,,percent of total billed charges,20% of total billed charges,418.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1361.1,65,,,percent of total billed charges,65% of total billed charges,1361.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1478,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1256.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1478,
VAGINAL SPEC DISP M,3250153,CDM,271,RC,,,outpatient,,,13.45,6.73,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.69,20,,,percent of total billed charges,20% of total billed charges,2.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.69,20,,,percent of total billed charges,20% of total billed charges,2.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.74,65,,,percent of total billed charges,65% of total billed charges,8.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.69,53.67,
VAGINAL SPEC DSP SM,3250051,CDM,271,RC,,,outpatient,,,11.1,5.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.22,20,,,percent of total billed charges,20% of total billed charges,2.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.22,20,,,percent of total billed charges,20% of total billed charges,2.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.22,65,,,percent of total billed charges,65% of total billed charges,7.22,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.22,53.67,
VALPROIC ACID,3300199,CDM,301,RC,80164,HCPCS,outpatient,,,71,35.5,,46.15,65,,,percent of total billed charges,65% of total billed charges,48.28,68,,,percent of total billed charges,68% of total billed charges,19.23,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.2,20,,,percent of total billed charges,20% of total billed charges,14.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.15,65,,,percent of total billed charges,65% of total billed charges,46.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.2,48.28,
VALPROIC ACID LIQ [250 MG,3500833,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
VALSARTAN TAB [160 MG],3500835,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
VANCOMYCIN HCL CAP [125 M,3501054,CDM,250,RC,,,outpatient,,,156.55,78.28,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.31,20,,,percent of total billed charges,20% of total billed charges,31.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.31,20,,,percent of total billed charges,20% of total billed charges,31.31,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,101.76,65,,,percent of total billed charges,65% of total billed charges,101.76,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,93.93,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,31.31,101.76,
VANCOMYCIN HCL INJ 750 MG VIAL,3501141,CDM,636,RC,J3370,HCPCS,outpatient,,,51.3,25.65,,,,,,other,Not reimbursable per contract ,34.88,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.26,20,,,percent of total billed charges,20% of total billed charges,10.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.26,20,,,percent of total billed charges,20% of total billed charges,10.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,41.04,80,,,case rate,80% for high cost drug carve out,43.61,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.26,43.61,
VANCOMYCIN INJ 1 GM,3501000,CDM,636,RC,J3370,HCPCS,outpatient,,,86.65,43.33,,,,,,other,Not reimbursable per contract ,58.92,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.33,20,,,percent of total billed charges,20% of total billed charges,17.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.33,20,,,percent of total billed charges,20% of total billed charges,17.33,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,69.32,80,,,case rate,80% for high cost drug carve out,73.65,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,51.99,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.33,73.65,
VANCOMYCIN INJ 500 MG,3500999,CDM,636,RC,J3370,HCPCS,outpatient,,,43.45,21.73,,,,,,other,Not reimbursable per contract ,29.55,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.69,20,,,percent of total billed charges,20% of total billed charges,8.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.69,20,,,percent of total billed charges,20% of total billed charges,8.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.76,80,,,case rate,80% for high cost drug carve out,36.93,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.69,36.93,
VANCOMYCIN LEVEL,3300263,CDM,301,RC,80202,HCPCS,outpatient,,,130,65,,84.5,65,,,percent of total billed charges,65% of total billed charges,88.4,68,,,percent of total billed charges,68% of total billed charges,19.23,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,20,,,percent of total billed charges,20% of total billed charges,26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26,20,,,percent of total billed charges,20% of total billed charges,26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,84.5,65,,,percent of total billed charges,65% of total billed charges,84.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.23,88.4,
VAPOTHERM AD CANNULA,4000064,CDM,270,RC,,,outpatient,,,261.1,130.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.22,20,,,percent of total billed charges,20% of total billed charges,52.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.22,20,,,percent of total billed charges,20% of total billed charges,52.22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,169.72,65,,,percent of total billed charges,65% of total billed charges,169.72,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,156.66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.22,169.72,
VARICELLA IGM,3300633,CDM,302,RC,86787,HCPCS,outpatient,,,38,19,,24.7,65,,,percent of total billed charges,65% of total billed charges,25.84,68,,,percent of total billed charges,68% of total billed charges,18.29,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.6,20,,,percent of total billed charges,20% of total billed charges,7.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.6,20,,,percent of total billed charges,20% of total billed charges,7.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.7,65,,,percent of total billed charges,65% of total billed charges,24.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.6,25.84,
VARICELLA ZOSTER,3300511,CDM,302,RC,86787,HCPCS,outpatient,,,100,50,,65,65,,,percent of total billed charges,65% of total billed charges,68,68,,,percent of total billed charges,68% of total billed charges,18.29,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,65,,,percent of total billed charges,65% of total billed charges,65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.29,68,
VASELINE GAUZE 3X18,3250413,CDM,272,RC,,,outpatient,,,6.3,3.15,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.26,20,,,percent of total billed charges,20% of total billed charges,1.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.26,20,,,percent of total billed charges,20% of total billed charges,1.26,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.1,65,,,percent of total billed charges,65% of total billed charges,4.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.78,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.26,53.67,
VASELINE GAUZE 3X36,3250315,CDM,272,RC,,,outpatient,,,6.95,3.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.39,20,,,percent of total billed charges,20% of total billed charges,1.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.39,20,,,percent of total billed charges,20% of total billed charges,1.39,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.52,65,,,percent of total billed charges,65% of total billed charges,4.52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.39,53.67,
VASELING GAUZE 1X8,3250469,CDM,272,RC,,,outpatient,,,9.95,4.98,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.99,20,,,percent of total billed charges,20% of total billed charges,1.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.99,20,,,percent of total billed charges,20% of total billed charges,1.99,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.47,65,,,percent of total billed charges,65% of total billed charges,6.47,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.99,53.67,
VASOINTESTINAL PEPTI,3300287,CDM,301,RC,84586,HCPCS,outpatient,,,160,80,,104,65,,,percent of total billed charges,65% of total billed charges,108.8,68,,,percent of total billed charges,68% of total billed charges,26.52,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32,20,,,percent of total billed charges,20% of total billed charges,32,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,104,65,,,percent of total billed charges,65% of total billed charges,104,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,80,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.52,108.8,
VASOPRESSIN INJ [20 UNT/M,3500837,CDM,636,RC,,,outpatient,,,711.25,355.63,,462.31,65,,,percent of total billed charges,reimbursed when threshold exceeds 500$,483.65,68,,,percent of total billed charges,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.25,20,,,percent of total billed charges,20% of total billed charges,142.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.25,20,,,percent of total billed charges,20% of total billed charges,142.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,569,80,,,case rate,80% for high cost drug carve out,604.56,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,426.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,142.25,604.56,
VECURONIUM BROMIDE INJ [1,3501046,CDM,250,RC,,,outpatient,,,43.2,21.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.64,20,,,percent of total billed charges,20% of total billed charges,8.64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.64,20,,,percent of total billed charges,20% of total billed charges,8.64,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.08,65,,,percent of total billed charges,65% of total billed charges,28.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,25.92,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.64,53.67,
VENLAFAXINE TAB [37.5 MG],3500838,CDM,250,RC,,,outpatient,,,10,5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2,20,,,percent of total billed charges,20% of total billed charges,2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.5,65,,,percent of total billed charges,65% of total billed charges,6.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2,53.67,
VENLAFAXINE TAB [75 MG],3500839,CDM,250,RC,,,outpatient,,,10.95,5.48,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.19,20,,,percent of total billed charges,20% of total billed charges,2.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.19,20,,,percent of total billed charges,20% of total billed charges,2.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.12,65,,,percent of total billed charges,65% of total billed charges,7.12,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.19,53.67,
VENLAFAXINE XR CAP  [150,3500840,CDM,250,RC,,,outpatient,,,22.9,11.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.58,20,,,percent of total billed charges,20% of total billed charges,4.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.58,20,,,percent of total billed charges,20% of total billed charges,4.58,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.89,65,,,percent of total billed charges,65% of total billed charges,14.89,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.74,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.58,53.67,
VENLAFAXINE XR CAP [37.5,3500841,CDM,250,RC,,,outpatient,,,20.85,10.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.17,20,,,percent of total billed charges,20% of total billed charges,4.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.17,20,,,percent of total billed charges,20% of total billed charges,4.17,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.55,65,,,percent of total billed charges,65% of total billed charges,13.55,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.51,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.17,53.67,
VENLAFAXINE XR CAP [75 MG,3500842,CDM,250,RC,,,outpatient,,,23.35,11.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.67,20,,,percent of total billed charges,20% of total billed charges,4.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.67,20,,,percent of total billed charges,20% of total billed charges,4.67,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.18,65,,,percent of total billed charges,65% of total billed charges,15.18,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14.01,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.67,53.67,
VENOFER INJ 200MG/10 ML,3500462,CDM,636,RC,J1756,HCPCS,outpatient,,,480,240,,,,,,other,Not reimbursable per contract ,326.4,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,20,,,percent of total billed charges,20% of total billed charges,96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,96,20,,,percent of total billed charges,20% of total billed charges,96,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,384,80,,,case rate,80% for high cost drug carve out,408,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,288,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,96,408,
VENT USAGE/ SUB/DA,3170079,CDM,410,RC,94003,HCPCS,outpatient,,,907.65,453.83,,589.97,65,,,percent of total billed charges,65% of total billed charges,617.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,181.53,20,,,percent of total billed charges,20% of total billed charges,181.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,181.53,20,,,percent of total billed charges,20% of total billed charges,181.53,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,589.97,65,,,percent of total billed charges,65% of total billed charges,589.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,544.59,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,617.2,
VENTILATOR/INIT/DAY,3170075,CDM,410,RC,94002,HCPCS,outpatient,,,1500,750,,975,65,,,percent of total billed charges,65% of total billed charges,1020,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,300,20,,,percent of total billed charges,20% of total billed charges,300,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,975,65,,,percent of total billed charges,65% of total billed charges,975,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,74,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,900,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1020,
VERAPAMIL 120MG,3501097,CDM,250,RC,,,outpatient,,,9.35,4.68,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.87,20,,,percent of total billed charges,20% of total billed charges,1.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.87,20,,,percent of total billed charges,20% of total billed charges,1.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.08,65,,,percent of total billed charges,65% of total billed charges,6.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.87,53.67,
VERAPAMIL INJ [2.5 MG/ML],3500844,CDM,636,RC,J3490,HCPCS,outpatient,,,56.25,28.13,,,,,,other,Not reimbursable per contract ,38.25,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.25,20,,,percent of total billed charges,20% of total billed charges,11.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.25,20,,,percent of total billed charges,20% of total billed charges,11.25,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45,80,,,case rate,80% for high cost drug carve out,47.81,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,33.75,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.25,47.81,
VERAPAMIL SR CAP [180 MG],3501049,CDM,250,RC,,,outpatient,,,17.55,8.78,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.51,20,,,percent of total billed charges,20% of total billed charges,3.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.51,20,,,percent of total billed charges,20% of total billed charges,3.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.41,65,,,percent of total billed charges,65% of total billed charges,11.41,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.53,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.51,53.67,
VERAPAMIL SR TAB [240 MG],3500846,CDM,250,RC,,,outpatient,,,15.5,7.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.08,65,,,percent of total billed charges,65% of total billed charges,10.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.1,53.67,
VERAPAMIL TAB [80 MG],3500847,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
VIOKACE PANCRELIPASE 10.4-39,3521955,CDM,637,RC,J3490,HCPCS,outpatient,,,19.35,9.68,,12.58,65,,,percent of total billed charges,65% of total billed charges,13.16,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.87,20,,,percent of total billed charges,20% of total billed charges,3.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.87,20,,,percent of total billed charges,20% of total billed charges,3.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.58,65,,,percent of total billed charges,65% of total billed charges,12.58,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.87,53.67,
"Viral Culture, SO",3300907,CDM,306,RC,87252,HCPCS,outpatient,,,220,110,,143,65,,,percent of total billed charges,65% of total billed charges,149.6,68,,,percent of total billed charges,68% of total billed charges,37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,44,20,,,percent of total billed charges,20% of total billed charges,44,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,143,65,,,percent of total billed charges,65% of total billed charges,143,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,110,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,132,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,37,149.6,
VISION VITAMINS TAB,3500848,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
VISUAL ACUITY,3700205,CDM,521,RC,99172,HCPCS,outpatient,,,58,29,,37.7,65,,,percent of total billed charges,65% of total billed charges,39.44,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.6,20,,,percent of total billed charges,20% of total billed charges,11.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.6,20,,,percent of total billed charges,20% of total billed charges,11.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.7,65,,,percent of total billed charges,65% of total billed charges,37.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.6,39.44,
VIT B1 PYROPHOS,3300281,CDM,301,RC,84425,HCPCS,outpatient,,,103,51.5,,66.95,65,,,percent of total billed charges,65% of total billed charges,70.04,68,,,percent of total billed charges,68% of total billed charges,12.09,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.6,20,,,percent of total billed charges,20% of total billed charges,20.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.6,20,,,percent of total billed charges,20% of total billed charges,20.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66.95,65,,,percent of total billed charges,65% of total billed charges,66.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,51.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,61.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.09,70.04,
"VIT D 1,25 DIHYDROXY",3300457,CDM,301,RC,82652,HCPCS,outpatient,,,58,29,,37.7,65,,,percent of total billed charges,65% of total billed charges,39.44,68,,,percent of total billed charges,68% of total billed charges,54.63,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.6,20,,,percent of total billed charges,20% of total billed charges,11.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.6,20,,,percent of total billed charges,20% of total billed charges,11.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,37.7,65,,,percent of total billed charges,65% of total billed charges,37.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,34.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.6,54.63,
"VIT D, 25 HYDROXY",3300459,CDM,301,RC,82306,HCPCS,outpatient,,,98,49,,63.7,65,,,percent of total billed charges,65% of total billed charges,66.64,68,,,percent of total billed charges,68% of total billed charges,42.01,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,19.6,20,,,percent of total billed charges,20% of total billed charges,19.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.7,65,,,percent of total billed charges,65% of total billed charges,63.7,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,58.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,19.6,66.64,
"VIT- B COM/ C/ FE,FA/MIN",3500849,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
VIT- B COMPLEX,3500850,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
VIT- B-1 INJ [100 MG/ML],3500851,CDM,636,RC,J3411,HCPCS,outpatient,,,26.9,13.45,,,,,,other,Not reimbursable per contract ,18.29,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.38,20,,,percent of total billed charges,20% of total billed charges,5.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5.38,20,,,percent of total billed charges,20% of total billed charges,5.38,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,21.52,80,,,case rate,80% for high cost drug carve out,22.87,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.14,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5.38,22.87,
VIT- B-1 TAB [100 MG],3500852,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
VIT- B-12 INJ [1000 MCG/M,3500853,CDM,636,RC,J3420,HCPCS,outpatient,,,37.4,18.7,,,,,,other,Not reimbursable per contract ,25.43,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.48,20,,,percent of total billed charges,20% of total billed charges,7.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.48,20,,,percent of total billed charges,20% of total billed charges,7.48,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,29.92,80,,,case rate,80% for high cost drug carve out,31.79,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.44,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.48,31.79,
VIT- B-12 TAB [500 MCG],3500854,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
VIT- B-6 TAB [50 MG],3500855,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
VIT- C TAB [500 MG],3500856,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
"VIT- D TAB[1,000 U]",3500859,CDM,250,RC,,,outpatient,,,3,1.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.6,20,,,percent of total billed charges,20% of total billed charges,0.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.95,65,,,percent of total billed charges,65% of total billed charges,1.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.6,53.67,
VIT- D3 5000 IU,3500857,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
VIT- E CAP [400 UNT],3500860,CDM,250,RC,J3490,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
VIT- K INJ [10 MG/ML],3500861,CDM,636,RC,J3430,HCPCS,outpatient,,,230.95,115.48,,,,,,other,Not reimbursable per contract ,157.05,68,,,case rate,68% of high cost drug carve out,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.19,20,,,percent of total billed charges,20% of total billed charges,46.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,46.19,20,,,percent of total billed charges,20% of total billed charges,46.19,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,184.76,80,,,case rate,80% for high cost drug carve out,196.31,85,,,case rate,85% for high cost drug carve out,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,138.57,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,46.19,196.31,
"VIT-D CAP [50,000 IU]",3500996,CDM,250,RC,,,outpatient,,,15.5,7.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.1,20,,,percent of total billed charges,20% of total billed charges,3.1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.08,65,,,percent of total billed charges,65% of total billed charges,10.08,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,9.3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.1,53.67,
VMA 24 HR UA,3300123,CDM,301,RC,84585,HCPCS,outpatient,,,80,40,,52,65,,,percent of total billed charges,65% of total billed charges,54.4,68,,,percent of total billed charges,68% of total billed charges,22,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16,20,,,percent of total billed charges,20% of total billed charges,16,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52,65,,,percent of total billed charges,65% of total billed charges,52,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,48,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16,54.4,
VOID CYSTO INJ,3400134,CDM,361,RC,51600,HCPCS,outpatient,,,150,75,,97.5,65,,,percent of total billed charges,65% of total billed charges,102,68,,,percent of total billed charges,68% of total billed charges,312,100,,,case rate,100% of BCBS asc grouper rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30,20,,,percent of total billed charges,20% of total billed charges,30,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.5,65,,,percent of total billed charges,65% of total billed charges,97.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,178,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,90,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30,312,
VOID CYSTO INJ,3440439,CDM,972,RC,51600,HCPCS,outpatient,,,110,55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.54,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,49.07,110,,,fee schedule,110% of Medicare physician fee schedule,49.07,110,,,fee schedule,110% of Medicare physician fee schedule,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,51.3,115,,,fee schedule,115% of Medicare physician fee schedule,82.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,29.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,56.43,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,29.54,82.14,
VOID CYSTOURETHOGRAM,3400057,CDM,320,RC,74455,HCPCS,outpatient,,,318.28,159.14,,206.88,65,,,percent of total billed charges,65% of total billed charges,216.43,68,,,percent of total billed charges,68% of total billed charges,52.72,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.66,20,,,percent of total billed charges,20% of total billed charges,63.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,63.66,20,,,percent of total billed charges,20% of total billed charges,63.66,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,206.88,65,,,percent of total billed charges,65% of total billed charges,206.88,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,190.97,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.72,216.43,
VOID CYSTOURETHOGRAM,3440287,CDM,972,RC,74455,HCPCS,outpatient,,,67,33.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,44.83,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,73.7,110,,,fee schedule,110% of Medicare physician fee schedule,73.7,110,,,fee schedule,110% of Medicare physician fee schedule,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,253.45,115,,,fee schedule,115% of Medicare physician fee schedule,97.43,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.83,100,,,fee schedule,100% of FL Medicaid fee schedule ,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,84.76,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,44.83,253.45,
VORICONAZOLE 200 MG TAB,3501136,CDM,250,RC,,,outpatient,,,87.3,43.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.46,20,,,percent of total billed charges,20% of total billed charges,17.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,17.46,20,,,percent of total billed charges,20% of total billed charges,17.46,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.75,65,,,percent of total billed charges,65% of total billed charges,56.75,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,52.38,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.46,56.75,
VZV AG BY DF,3300741,CDM,306,RC,87290,HCPCS,outpatient,,,70,35,,45.5,65,,,percent of total billed charges,65% of total billed charges,47.6,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14,20,,,percent of total billed charges,20% of total billed charges,14,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.5,65,,,percent of total billed charges,65% of total billed charges,45.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,35,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,42,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,14,47.6,
W/C MGMT TRAINING 15 MIN,3600046,CDM,430,RC,97542,HCPCS,outpatient,,,65,32.5,,42.25,65,,,percent of total billed charges,65% of total billed charges,44.2,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,20,,,percent of total billed charges,20% of total billed charges,13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,20,,,percent of total billed charges,20% of total billed charges,13,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,42.25,65,,,percent of total billed charges,65% of total billed charges,42.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82,100,,,case rate,100% of case rate fee,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,39,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13,82,
WARFARIN TAB  [1 MG],3500862,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
WARFARIN TAB [10 MG],3500863,CDM,250,RC,,,outpatient,,,19.2,9.6,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,20,,,percent of total billed charges,20% of total billed charges,3.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.84,20,,,percent of total billed charges,20% of total billed charges,3.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.48,65,,,percent of total billed charges,65% of total billed charges,12.48,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.84,53.67,
WARFARIN TAB [2 MG],3500864,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
WARFARIN TAB [2.5 MG],3500865,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
WARFARIN TAB [3 MG],3500866,CDM,250,RC,,,outpatient,,,13.4,6.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.68,20,,,percent of total billed charges,20% of total billed charges,2.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.68,20,,,percent of total billed charges,20% of total billed charges,2.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.71,65,,,percent of total billed charges,65% of total billed charges,8.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.68,53.67,
WARFARIN TAB [4 MG],3500867,CDM,250,RC,,,outpatient,,,13.4,6.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.68,20,,,percent of total billed charges,20% of total billed charges,2.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.68,20,,,percent of total billed charges,20% of total billed charges,2.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.71,65,,,percent of total billed charges,65% of total billed charges,8.71,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.68,53.67,
WARFARIN TAB [5 MG],3500868,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
WARFARIN TAB [7.5 MG],3500869,CDM,250,RC,,,outpatient,,,18.5,9.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.7,20,,,percent of total billed charges,20% of total billed charges,3.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.7,20,,,percent of total billed charges,20% of total billed charges,3.7,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.03,65,,,percent of total billed charges,65% of total billed charges,12.03,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.1,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.7,53.67,
WATER STERILE INJ,3500870,CDM,250,RC,,,outpatient,,,25,12.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,5,20,,,percent of total billed charges,20% of total billed charges,5,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,16.25,65,,,percent of total billed charges,65% of total billed charges,16.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,5,53.67,
"WATER, STERILE 1000 BAG",4000060,CDM,272,RC,,,outpatient,,,34.2,17.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.84,20,,,percent of total billed charges,20% of total billed charges,6.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,6.84,20,,,percent of total billed charges,20% of total billed charges,6.84,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22.23,65,,,percent of total billed charges,65% of total billed charges,22.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,6.84,53.67,
WBC,3300671,CDM,305,RC,85048,HCPCS,outpatient,,,20,10,,13,65,,,percent of total billed charges,65% of total billed charges,13.6,68,,,percent of total billed charges,68% of total billed charges,3.61,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4,20,,,percent of total billed charges,20% of total billed charges,4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13,65,,,percent of total billed charges,65% of total billed charges,13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.61,13.6,
WESTERN BLOT,3300493,CDM,302,RC,86689,HCPCS,outpatient,,,159,79.5,,103.35,65,,,percent of total billed charges,65% of total billed charges,108.12,68,,,percent of total billed charges,68% of total billed charges,27.47,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.8,20,,,percent of total billed charges,20% of total billed charges,31.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.8,20,,,percent of total billed charges,20% of total billed charges,31.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.35,65,,,percent of total billed charges,65% of total billed charges,103.35,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,27.47,108.12,
WET MOUNTS,3300895,CDM,310,RC,Q0111,HCPCS,outpatient,,,5,2.5,,3.25,65,,,percent of total billed charges,65% of total billed charges,3.4,68,,,percent of total billed charges,68% of total billed charges,6.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,6.06,
WET PREP,3300739,CDM,306,RC,87210,HCPCS,outpatient,,,23,11.5,,14.95,65,,,percent of total billed charges,65% of total billed charges,15.64,68,,,percent of total billed charges,68% of total billed charges,6.06,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.6,20,,,percent of total billed charges,20% of total billed charges,4.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,14.95,65,,,percent of total billed charges,65% of total billed charges,14.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,13.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.6,15.64,
WHISTLE CATHETER 4FR,6215790,CDM,272,RC,,,outpatient,,,162.53,81.27,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.51,20,,,percent of total billed charges,20% of total billed charges,32.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.51,20,,,percent of total billed charges,20% of total billed charges,32.51,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,105.64,65,,,percent of total billed charges,65% of total billed charges,105.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,97.52,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.51,105.64,
WOUND EXPLOR CHEST,3231159,CDM,450,RC,20101,HCPCS,outpatient,,,1934.34,967.17,,1257.32,65,,,percent of total billed charges,65% of total billed charges,1315.35,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,386.87,20,,,percent of total billed charges,20% of total billed charges,386.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,386.87,20,,,percent of total billed charges,20% of total billed charges,386.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1257.32,65,,,percent of total billed charges,65% of total billed charges,1257.32,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,665,100,,,case rate,100% of asc tier grouper rate,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1160.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,1315.35,
WR COMP EA ADD 5 CM,3231141,CDM,450,RC,,,outpatient,,,110,55,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,22,20,,,percent of total billed charges,20% of total billed charges,22,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,71.5,65,,,percent of total billed charges,65% of total billed charges,71.5,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38.5,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,66,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22,71.5,
WR COMPLEX SCALP EXT,3231143,CDM,450,RC,,,outpatient,,,360,180,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,20,,,percent of total billed charges,20% of total billed charges,72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,72,20,,,percent of total billed charges,20% of total billed charges,72,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,234,65,,,percent of total billed charges,65% of total billed charges,234,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,126,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,216,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,234,
WR SIMPLE 20.1-30CM,3231069,CDM,450,RC,,,outpatient,,,651,325.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.2,20,,,percent of total billed charges,20% of total billed charges,130.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130.2,20,,,percent of total billed charges,20% of total billed charges,130.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,423.15,65,,,percent of total billed charges,65% of total billed charges,423.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,227.85,35,,,percent of total billed charges,35% of total billed charges,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,390.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,53.67,423.15,
WRIST BIL 2 VIEWS,3440289,CDM,972,RC,73100,HCPCS,outpatient,,,64.9,32.45,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.48,110,,,fee schedule,110% of Medicare physician fee schedule,36.48,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.53,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,214.53,
WRIST BIL MIN:3 VIEW,3440291,CDM,972,RC,73110,HCPCS,outpatient,,,82.5,41.25,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.86,110,,,fee schedule,110% of Medicare physician fee schedule,43.86,110,,,fee schedule,110% of Medicare physician fee schedule,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.25,115,,,fee schedule,115% of Medicare physician fee schedule,71.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.35,222.25,
WRIST L 2 VIEWS,3440293,CDM,972,RC,73100,HCPCS,outpatient,,,45.1,22.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.48,110,,,fee schedule,110% of Medicare physician fee schedule,36.48,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.53,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,214.53,
WRIST L MIN 3 V,3440295,CDM,972,RC,73110,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.86,110,,,fee schedule,110% of Medicare physician fee schedule,43.86,110,,,fee schedule,110% of Medicare physician fee schedule,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.25,115,,,fee schedule,115% of Medicare physician fee schedule,71.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.35,222.25,
WRIST R 2 VIEWS,3440297,CDM,972,RC,73100,HCPCS,outpatient,,,45.1,22.55,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,36.48,110,,,fee schedule,110% of Medicare physician fee schedule,36.48,110,,,fee schedule,110% of Medicare physician fee schedule,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,214.53,115,,,fee schedule,115% of Medicare physician fee schedule,68.51,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,15.91,100,,,fee schedule,100% of FL Medicaid fee schedule ,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,41.95,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,15.91,214.53,
WRIST R MIN: 3 VIEW,3440299,CDM,972,RC,73110,HCPCS,outpatient,,,47.3,23.65,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,43.86,110,,,fee schedule,110% of Medicare physician fee schedule,43.86,110,,,fee schedule,110% of Medicare physician fee schedule,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.25,115,,,fee schedule,115% of Medicare physician fee schedule,71.95,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,19.35,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.44,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,19.35,222.25,
WRIST-BIL 2 VIEWS,3400103,CDM,320,RC,73100,HCPCS,outpatient,,,152,76,,98.8,65,,,percent of total billed charges,65% of total billed charges,103.36,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.4,20,,,percent of total billed charges,20% of total billed charges,30.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,30.4,20,,,percent of total billed charges,20% of total billed charges,30.4,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,98.8,65,,,percent of total billed charges,65% of total billed charges,98.8,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,91.2,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
WRIST-BIL MIN:3 VIEW,3400105,CDM,320,RC,73110,HCPCS,outpatient,,,159.5,79.75,,103.68,65,,,percent of total billed charges,65% of total billed charges,108.46,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.9,20,,,percent of total billed charges,20% of total billed charges,31.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,31.9,20,,,percent of total billed charges,20% of total billed charges,31.9,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,103.68,65,,,percent of total billed charges,65% of total billed charges,103.68,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,95.7,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
WRIST-L 2 VIEWS,3400022,CDM,320,RC,73100,HCPCS,outpatient,,,100,50,,65,65,,,percent of total billed charges,65% of total billed charges,68,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,65,,,percent of total billed charges,65% of total billed charges,65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
WRIST-L MIN 3 VIEWS,3400021,CDM,320,RC,73110,HCPCS,outpatient,,,126.5,63.25,,82.23,65,,,percent of total billed charges,65% of total billed charges,86.02,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.23,65,,,percent of total billed charges,65% of total billed charges,82.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
WRIST-R 2 VIEWS,3400102,CDM,320,RC,73100,HCPCS,outpatient,,,100,50,,65,65,,,percent of total billed charges,65% of total billed charges,68,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20,20,,,percent of total billed charges,20% of total billed charges,20,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65,65,,,percent of total billed charges,65% of total billed charges,65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
WRIST-R MIN 3 VIEW,3400104,CDM,320,RC,73110,HCPCS,outpatient,,,126.5,63.25,,82.23,65,,,percent of total billed charges,65% of total billed charges,86.02,68,,,percent of total billed charges,68% of total billed charges,17.73,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.3,20,,,percent of total billed charges,20% of total billed charges,25.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,82.23,65,,,percent of total billed charges,65% of total billed charges,82.23,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,75.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,17.73,180,
X-RAY  LEG INFANT 2 VIEWS,3400199,CDM,320,RC,73592,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,16.46,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,16.46,180,
X-RAY  NECK SPINE 4+ VIEW,3400196,CDM,320,RC,72050,HCPCS,outpatient,,,300,150,,195,65,,,percent of total billed charges,65% of total billed charges,204,68,,,percent of total billed charges,68% of total billed charges,30.04,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60,20,,,percent of total billed charges,20% of total billed charges,60,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,195,65,,,percent of total billed charges,65% of total billed charges,195,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,180,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,30.04,204,
X-RAY  NECK SPINE 4+ VIEW,3440453,CDM,972,RC,72050,HCPCS,outpatient,,,77,38.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.84,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.05,110,,,fee schedule,110% of Medicare physician fee schedule,57.05,110,,,fee schedule,110% of Medicare physician fee schedule,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,236.04,115,,,fee schedule,115% of Medicare physician fee schedule,77.44,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,24.84,100,,,fee schedule,100% of FL Medicaid fee schedule ,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,65.6,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,24.84,236.04,
X-RAY  RIBS 3 VIEWS BILAT,3400205,CDM,324,RC,71110,HCPCS,outpatient,,,263,131.5,,170.95,65,,,percent of total billed charges,65% of total billed charges,178.84,68,,,percent of total billed charges,68% of total billed charges,26.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.6,20,,,percent of total billed charges,20% of total billed charges,52.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,52.6,20,,,percent of total billed charges,20% of total billed charges,52.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,170.95,65,,,percent of total billed charges,65% of total billed charges,170.95,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,157.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.36,180,
X-RAY LEG INFANT 2 VIEW,3440483,CDM,972,RC,73592,HCPCS,outpatient,,,47,23.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.54,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,34.02,110,,,fee schedule,110% of Medicare physician fee schedule,34.02,110,,,fee schedule,110% of Medicare physician fee schedule,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,211.97,115,,,fee schedule,115% of Medicare physician fee schedule,67.14,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,14.54,100,,,fee schedule,100% of FL Medicaid fee schedule ,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,39.13,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,14.54,211.97,
X-RAY PEL & HIPS 2+VIEW,3440481,CDM,972,RC,73521,HCPCS,outpatient,,,47,23.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.69,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,44.32,110,,,fee schedule,110% of Medicare physician fee schedule,44.32,110,,,fee schedule,110% of Medicare physician fee schedule,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,222.73,115,,,fee schedule,115% of Medicare physician fee schedule,73.29,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.69,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,50.97,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.69,222.73,
X-RAY PELV & HIPS 2+ VIEW,3400198,CDM,320,RC,73521,HCPCS,outpatient,,,200,100,,130,65,,,percent of total billed charges,65% of total billed charges,136,68,,,percent of total billed charges,68% of total billed charges,22.37,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,40,20,,,percent of total billed charges,20% of total billed charges,40,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,130,65,,,percent of total billed charges,65% of total billed charges,130,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,120,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,22.37,180,
X-RAY RIBS 3 VIEWS BILAT,3440449,CDM,972,RC,71110,HCPCS,outpatient,,,47,23.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,47.28,110,,,fee schedule,110% of Medicare physician fee schedule,47.28,110,,,fee schedule,110% of Medicare physician fee schedule,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,225.83,115,,,fee schedule,115% of Medicare physician fee schedule,73.18,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,20.58,100,,,fee schedule,100% of FL Medicaid fee schedule ,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,54.37,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,20.58,225.83,
X-RAY SI JOINTS 3+ VIEWS,3400197,CDM,320,RC,72202,HCPCS,outpatient,,,266,133,,172.9,65,,,percent of total billed charges,65% of total billed charges,180.88,68,,,percent of total billed charges,68% of total billed charges,20.77,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.2,20,,,percent of total billed charges,20% of total billed charges,53.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,53.2,20,,,percent of total billed charges,20% of total billed charges,53.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,172.9,65,,,percent of total billed charges,65% of total billed charges,172.9,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,159.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.77,180.88,
X-RAY SI JOINTS 3+ VIEWS,3440455,CDM,972,RC,72202,HCPCS,outpatient,,,47,23.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.05,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,42.24,110,,,fee schedule,110% of Medicare physician fee schedule,42.24,110,,,fee schedule,110% of Medicare physician fee schedule,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,220.56,115,,,fee schedule,115% of Medicare physician fee schedule,70.65,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,18.05,100,,,fee schedule,100% of FL Medicaid fee schedule ,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,48.58,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,18.05,220.56,
XARELTO TAB [10 MG],3501057,CDM,250,RC,,,outpatient,,,94,47,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.1,65,,,percent of total billed charges,65% of total billed charges,61.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.8,61.1,
XARELTO TAB [15 MG],3501045,CDM,250,RC,,,outpatient,,,94,47,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.1,65,,,percent of total billed charges,65% of total billed charges,61.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.8,61.1,
XARELTO TAB [20 MG],3501053,CDM,250,RC,,,outpatient,,,94,47,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,18.8,20,,,percent of total billed charges,20% of total billed charges,18.8,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,61.1,65,,,percent of total billed charges,65% of total billed charges,61.1,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,56.4,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,18.8,61.1,
XERO FORM 1X8,6215888,CDM,272,RC,,,outpatient,,,3.4,1.7,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.68,20,,,percent of total billed charges,20% of total billed charges,0.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.68,20,,,percent of total billed charges,20% of total billed charges,0.68,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.21,65,,,percent of total billed charges,65% of total billed charges,2.21,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.04,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.68,53.67,
XEROFORM STRIP 1X8,3250627,CDM,272,RC,,,outpatient,,,4.85,2.43,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.97,20,,,percent of total billed charges,20% of total billed charges,0.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,0.97,20,,,percent of total billed charges,20% of total billed charges,0.97,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.15,65,,,percent of total billed charges,65% of total billed charges,3.15,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.91,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,0.97,53.67,
XYLOCAINE 2% JELLY [30 GM,3500871,CDM,250,RC,,,outpatient,,,13.9,6.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.78,20,,,percent of total billed charges,20% of total billed charges,2.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,2.78,20,,,percent of total billed charges,20% of total billed charges,2.78,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,9.04,65,,,percent of total billed charges,65% of total billed charges,9.04,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.34,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,2.78,53.67,
Y-PORT CONNECTOR,3250619,CDM,272,RC,,,outpatient,,,38.75,19.38,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.75,20,,,percent of total billed charges,20% of total billed charges,7.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,7.75,20,,,percent of total billed charges,20% of total billed charges,7.75,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,25.19,65,,,percent of total billed charges,65% of total billed charges,25.19,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,23.25,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,7.75,53.67,
YANKAUER SUC TIP K87,3250515,CDM,272,RC,,,outpatient,,,19.9,9.95,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.98,20,,,percent of total billed charges,20% of total billed charges,3.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.98,20,,,percent of total billed charges,20% of total billed charges,3.98,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.94,65,,,percent of total billed charges,65% of total billed charges,12.94,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.94,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.98,53.67,
YETHYLENE GLYCOL [17 GM],3500681,CDM,250,RC,,,outpatient,,,21.5,10.75,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.3,20,,,percent of total billed charges,20% of total billed charges,4.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,4.3,20,,,percent of total billed charges,20% of total billed charges,4.3,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,13.98,65,,,percent of total billed charges,65% of total billed charges,13.98,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,12.9,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,4.3,53.67,
Z-STAT W/MASK,4000013,CDM,270,RC,,,outpatient,,,219.45,109.73,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.89,20,,,percent of total billed charges,20% of total billed charges,43.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,43.89,20,,,percent of total billed charges,20% of total billed charges,43.89,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,142.64,65,,,percent of total billed charges,65% of total billed charges,142.64,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,131.67,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,43.89,142.64,
ZALEPLON CAP [5 MG],3501030,CDM,250,RC,J3490,HCPCS,outpatient,,,18.45,9.23,,11.99,65,,,percent of total billed charges,65% of total billed charges,12.55,68,,,percent of total billed charges,68% of total billed charges,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.69,20,,,percent of total billed charges,20% of total billed charges,3.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.69,20,,,percent of total billed charges,20% of total billed charges,3.69,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.99,65,,,percent of total billed charges,65% of total billed charges,11.99,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,11.07,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.69,53.67,
ZARONTIN,3300195,CDM,301,RC,80168,HCPCS,outpatient,,,101,50.5,,65.65,65,,,percent of total billed charges,65% of total billed charges,68.68,68,,,percent of total billed charges,68% of total billed charges,23.19,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,20.2,20,,,percent of total billed charges,20% of total billed charges,20.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,65.65,65,,,percent of total billed charges,65% of total billed charges,65.65,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,50.5,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,60.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,20.2,68.68,
ZINC,3300225,CDM,301,RC,84630,HCPCS,outpatient,,,76,38,,49.4,65,,,percent of total billed charges,65% of total billed charges,51.68,68,,,percent of total billed charges,68% of total billed charges,16.17,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.2,20,,,percent of total billed charges,20% of total billed charges,15.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,15.2,20,,,percent of total billed charges,20% of total billed charges,15.2,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,49.4,65,,,percent of total billed charges,65% of total billed charges,49.4,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,38,50,,,percent of total billed charges,50% of total billed charges,,,,,other,Not reimbursable per contract,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,45.6,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,15.2,51.68,
ZINC OXIDE 20% OINT,3500872,CDM,250,RC,,,outpatient,,,5.75,2.88,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1.15,20,,,percent of total billed charges,20% of total billed charges,1.15,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.74,65,,,percent of total billed charges,65% of total billed charges,3.74,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3.45,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1.15,53.67,
ZINC SULFATE CAP [220 MG],3500873,CDM,250,RC,,,outpatient,,,5,2.5,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,1,20,,,percent of total billed charges,20% of total billed charges,1,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3.25,65,,,percent of total billed charges,65% of total billed charges,3.25,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,3,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,1,53.67,
ZIPRASIDONE HCL CAP [20 M,3501067,CDM,250,RC,,,outpatient,,,44.35,22.18,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.87,20,,,percent of total billed charges,20% of total billed charges,8.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.87,20,,,percent of total billed charges,20% of total billed charges,8.87,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,28.83,65,,,percent of total billed charges,65% of total billed charges,28.83,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.61,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.87,53.67,
ZIPRASIDONE TAB (80MG),3501095,CDM,250,RC,,,outpatient,,,53.8,26.9,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.76,20,,,percent of total billed charges,20% of total billed charges,10.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,10.76,20,,,percent of total billed charges,20% of total billed charges,10.76,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,34.97,65,,,percent of total billed charges,65% of total billed charges,34.97,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,32.28,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,10.76,53.67,
ZOLPIDEM TAB [5 MG],3500876,CDM,250,RC,,,outpatient,,,40.2,20.1,,,,,,other,Not reimbursable per contract ,,,,,other,Not reimbursable per contract,,,,,other,Not separately reimbursable for physician per contract terms,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,20,,,percent of total billed charges,20% of total billed charges,8.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,8.04,20,,,percent of total billed charges,20% of total billed charges,8.04,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.13,65,,,percent of total billed charges,65% of total billed charges,26.13,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,,,other,Not reimbursable per contract,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,24.12,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,8.04,53.67,
ZYGOMATIC ARCH MIN 3,3400023,CDM,320,RC,70150,HCPCS,outpatient,,,133,66.5,,86.45,65,,,percent of total billed charges,65% of total billed charges,90.44,68,,,percent of total billed charges,68% of total billed charges,26.36,100,,,fee schedule,100% of BCBS outpatient fee schedule ,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.6,20,,,percent of total billed charges,20% of total billed charges,26.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,26.6,20,,,percent of total billed charges,20% of total billed charges,26.6,20,,,percent of total billed charges,20% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,86.45,65,,,percent of total billed charges,65% of total billed charges,86.45,65,,,percent of total billed charges,65% of total billed charges,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,180,100,,,case rate,100% of case rate fee,53.67,100,,,case rate,100% UHC Medicaid outpatient case rate,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,,,APG,,other,Reimbursed at 100% FL Medicaid APG rates. See APG rows for details,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,79.8,60,,,percent of total billed charges,60% of total billed charges for outpatient setting,26.36,180,
ZYGOMATIC ARCH MIN3V,3440301,CDM,972,RC,70150,HCPCS,outpatient,,,64,32,,,,,,other,Not reimbursable per contract ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid physician fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,,,,,other,Not separately reimbursable for physician per contract terms,,,,,other,Not separately reimbursable for physician per contract terms,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,50.36,110,,,fee schedule,110% of Medicare physician fee schedule,50.36,110,,,fee schedule,110% of Medicare physician fee schedule,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,229.05,115,,,fee schedule,115% of Medicare physician fee schedule,75.31,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,22.71,100,,,fee schedule,100% of FL Medicaid fee schedule ,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,57.91,100,,,fee schedule,Pays 100% medicare OPPS for physician setting,22.71,229.05,
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,1,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,149042.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,149042.3,149042.3,
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,2,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,67342.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,67342.55,67342.55,
"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",3,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,117261.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,117261.65,117261.65,
"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",4,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,80850,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,80850,80850,
LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,5,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,56925,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,56925,56925,
LIVER TRANSPLANT WITHOUT MCC,6,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26602.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26602.95,26602.95,
LUNG TRANSPLANT,7,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,67465.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,67465.2,67465.2,
SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,8,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28939.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28939.35,28939.35,
PANCREAS TRANSPLANT,10,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26474.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26474.8,26474.8,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",11,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28359.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28359.65,28359.65,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",12,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22026.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22026.95,22026.95,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",13,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14771.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14771.35,14771.35,
ALLOGENEIC BONE MARROW TRANSPLANT,14,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,63034.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,63034.95,63034.95,
AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,16,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33973.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33973.5,33973.5,
AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,17,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33973.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33973.5,33973.5,
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,18,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,202634.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,202634.85,202634.85,
SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,19,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,43964.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,43964.25,43964.25,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,20,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,46488.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,46488.2,46488.2,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,21,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33777.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33777.7,33777.7,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,22,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19121.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19121.85,19121.85,
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,23,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,31178.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,31178.4,31178.4,
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,24,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20838.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20838.4,20838.4,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,25,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24288,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24288,24288,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,26,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16242.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16242.05,16242.05,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,27,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13380.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13380.95,13380.95,
SPINAL PROCEDURES WITH MCC,28,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33143.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33143.55,33143.55,
SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,29,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18855.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18855.1,18855.1,
SPINAL PROCEDURES WITHOUT CC/MCC,30,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12754.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12754.5,12754.5,
VENTRICULAR SHUNT PROCEDURES WITH MCC,31,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22641.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22641.3,22641.3,
VENTRICULAR SHUNT PROCEDURES WITH CC,32,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11845.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11845.9,11845.9,
VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,33,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8925.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8925.95,8925.95,
CAROTID ARTERY STENT PROCEDURES WITH MCC,34,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21457.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21457.7,21457.7,
CAROTID ARTERY STENT PROCEDURES WITH CC,35,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12647.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12647.25,12647.25,
CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,36,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9945.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9945.1,9945.1,
EXTRACRANIAL PROCEDURES WITH MCC,37,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18565.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18565.8,18565.8,
EXTRACRANIAL PROCEDURES WITH CC,38,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8799.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8799.45,8799.45,
EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,39,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6275.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6275.5,6275.5,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",40,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21177.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21177.75,21177.75,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",41,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12268.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12268.85,12268.85,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",42,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9568.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9568.9,9568.9,
SPINAL DISORDERS AND INJURIES WITH CC/MCC,52,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10694.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10694.75,10694.75,
SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,53,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5410.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5410.9,5410.9,
NERVOUS SYSTEM NEOPLASMS WITH MCC,54,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8104.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8104.25,8104.25,
NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,55,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5902.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5902.6,5902.6,
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,56,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13167,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13167,13167,
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,57,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7497.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7497.6,7497.6,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,58,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9503.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9503.45,9503.45,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,59,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6529.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6529.6,6529.6,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,60,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4935.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4935.7,4935.7,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",61,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15415.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15415.4,15415.4,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",62,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10294.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10294.35,10294.35,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",63,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8177.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8177.4,8177.4,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,64,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11016.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11016.5,11016.5,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,65,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5590.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5590.2,5590.2,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,66,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3781.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3781.25,3781.25,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,67,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7792.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7792.95,7792.95,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,68,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4790.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4790.5,4790.5,
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,69,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4392.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4392.85,4392.85,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,70,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9842.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9842.25,9842.25,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,71,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5839.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5839.9,5839.9,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,72,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4306.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4306.5,4306.5,
CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,73,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8321.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8321.5,8321.5,
CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,74,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5644.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5644.1,5644.1,
VIRAL MENINGITIS WITH CC/MCC,75,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10525.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10525.9,10525.9,
VIRAL MENINGITIS WITHOUT CC/MCC,76,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5073.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5073.75,5073.75,
HYPERTENSIVE ENCEPHALOPATHY WITH MCC,77,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8309.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8309.95,8309.95,
HYPERTENSIVE ENCEPHALOPATHY WITH CC,78,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5592.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5592.95,5592.95,
HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,79,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4074.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4074.4,4074.4,
NONTRAUMATIC STUPOR AND COMA WITH MCC,80,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12147.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12147.85,12147.85,
NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,81,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5002.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5002.25,5002.25,
TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,82,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12530.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12530.65,12530.65,
TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,83,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7460.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7460.2,7460.2,
TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,84,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5058.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5058.35,5058.35,
TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,85,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12500.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12500.4,12500.4,
TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,86,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7244.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7244.05,7244.05,
TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,87,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4874.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4874.1,4874.1,
CONCUSSION WITH MCC,88,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8435.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8435.9,8435.9,
CONCUSSION WITH CC,89,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6324.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6324.45,6324.45,
CONCUSSION WITHOUT CC/MCC,90,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5141.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5141.4,5141.4,
OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,91,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9840.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9840.6,9840.6,
OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,92,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5643.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5643.55,5643.55,
OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,93,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4259.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4259.2,4259.2,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,94,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19924.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19924.85,19924.85,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,95,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13113.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13113.1,13113.1,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,96,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11988.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11988.35,11988.35,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,97,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20002.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20002.95,20002.95,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,98,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11849.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11849.75,11849.75,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,99,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7261.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7261.1,7261.1,
SEIZURES WITH MCC,100,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10903.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10903.75,10903.75,
SEIZURES WITHOUT MCC,101,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5002.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5002.8,5002.8,
HEADACHES WITH MCC,102,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6636.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6636.3,6636.3,
HEADACHES WITHOUT MCC,103,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4633.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4633.2,4633.2,
ORBITAL PROCEDURES WITH CC/MCC,113,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13790.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13790.15,13790.15,
ORBITAL PROCEDURES WITHOUT CC/MCC,114,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6774.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6774.9,6774.9,
EXTRAOCULAR PROCEDURES EXCEPT ORBIT,115,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8604.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8604.2,8604.2,
INTRAOCULAR PROCEDURES WITH CC/MCC,116,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10069.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10069.4,10069.4,
INTRAOCULAR PROCEDURES WITHOUT CC/MCC,117,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6591.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6591.2,6591.2,
ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,121,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7046.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7046.6,7046.6,
ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,122,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4094.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4094.75,4094.75,
NEUROLOGICAL EYE DISORDERS,123,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4422,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4422,4422,
OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,124,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7270.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7270.45,7270.45,
OTHER DISORDERS OF THE EYE WITHOUT MCC,125,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4386.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4386.25,4386.25,
SINUS AND MASTOID PROCEDURES WITH CC/MCC,135,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14586.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14586.55,14586.55,
SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,136,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5165.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5165.05,5165.05,
MOUTH PROCEDURES WITH CC/MCC,137,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8275.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8275.85,8275.85,
MOUTH PROCEDURES WITHOUT CC/MCC,138,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4761.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4761.35,4761.35,
SALIVARY GLAND PROCEDURES,139,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6532.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6532.35,6532.35,
MAJOR HEAD AND NECK PROCEDURES WITH MCC,140,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20779.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20779.55,20779.55,
MAJOR HEAD AND NECK PROCEDURES WITH CC,141,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11394.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11394.35,11394.35,
MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,142,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8497.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8497.5,8497.5,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",143,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18290.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18290.8,18290.8,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",144,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9517.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9517.75,9517.75,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",145,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6716.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6716.05,6716.05,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",146,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11610.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11610.5,11610.5,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",147,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6796.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6796.9,6796.9,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",148,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4893.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4893.35,4893.35,
DYSEQUILIBRIUM,149,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4095.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4095.85,4095.85,
EPISTAXIS WITH MCC,150,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7229.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7229.75,7229.75,
EPISTAXIS WITHOUT MCC,151,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4238.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4238.85,4238.85,
OTITIS MEDIA AND URI WITH MCC,152,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6535.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6535.1,6535.1,
OTITIS MEDIA AND URI WITHOUT MCC,153,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4041.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4041.4,4041.4,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",154,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8460.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8460.1,8460.1,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",155,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5206.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5206.3,5206.3,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",156,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3605.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3605.25,3605.25,
DENTAL AND ORAL DISEASES WITH MCC,157,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9388.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9388.5,9388.5,
DENTAL AND ORAL DISEASES WITH CC,158,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5161.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5161.75,5161.75,
DENTAL AND ORAL DISEASES WITHOUT CC/MCC,159,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3713.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3713.6,3713.6,
MAJOR CHEST PROCEDURES WITH MCC,163,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,25924.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,25924.8,25924.8,
MAJOR CHEST PROCEDURES WITH CC,164,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14027.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14027.2,14027.2,
MAJOR CHEST PROCEDURES WITHOUT CC/MCC,165,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10320.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10320.2,10320.2,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,166,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22317.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22317.9,22317.9,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,167,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10008.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10008.9,10008.9,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,168,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7456.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7456.35,7456.35,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,173,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16912.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16912.5,16912.5,
PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,175,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7716.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7716.5,7716.5,
PULMONARY EMBOLISM WITHOUT MCC,176,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4485.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4485.8,4485.8,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,177,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9330.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9330.2,9330.2,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,178,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5426.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5426.85,5426.85,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,179,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4198.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4198.15,4198.15,
RESPIRATORY NEOPLASMS WITH MCC,180,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9560.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9560.1,9560.1,
RESPIRATORY NEOPLASMS WITH CC,181,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6056.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6056.05,6056.05,
RESPIRATORY NEOPLASMS WITHOUT CC/MCC,182,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4174.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4174.5,4174.5,
MAJOR CHEST TRAUMA WITH MCC,183,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8659.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8659.75,8659.75,
MAJOR CHEST TRAUMA WITH CC,184,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5785.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5785.45,5785.45,
MAJOR CHEST TRAUMA WITHOUT CC/MCC,185,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4156.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4156.35,4156.35,
PLEURAL EFFUSION WITH MCC,186,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8536.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8536.55,8536.55,
PLEURAL EFFUSION WITH CC,187,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5479.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5479.65,5479.65,
PLEURAL EFFUSION WITHOUT CC/MCC,188,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4105.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4105.75,4105.75,
PULMONARY EDEMA AND RESPIRATORY FAILURE,189,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6776,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6776,6776,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,190,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6061,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6061,6061,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,191,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4669.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4669.5,4669.5,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,192,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3529.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3529.9,3529.9,
SIMPLE PNEUMONIA AND PLEURISY WITH MCC,193,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7296.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7296.3,7296.3,
SIMPLE PNEUMONIA AND PLEURISY WITH CC,194,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4522.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4522.1,4522.1,
SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,195,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3440.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3440.8,3440.8,
INTERSTITIAL LUNG DISEASE WITH MCC,196,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10424.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10424.7,10424.7,
INTERSTITIAL LUNG DISEASE WITH CC,197,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5486.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5486.25,5486.25,
INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,198,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4280.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4280.1,4280.1,
PNEUMOTHORAX WITH MCC,199,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9757.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9757.55,9757.55,
PNEUMOTHORAX WITH CC,200,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5923.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5923.5,5923.5,
PNEUMOTHORAX WITHOUT CC/MCC,201,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3883.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3883.55,3883.55,
BRONCHITIS AND ASTHMA WITH CC/MCC,202,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5266.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5266.25,5266.25,
BRONCHITIS AND ASTHMA WITHOUT CC/MCC,203,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3821.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3821.95,3821.95,
RESPIRATORY SIGNS AND SYMPTOMS,204,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4525.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4525.95,4525.95,
OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,205,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9956.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9956.65,9956.65,
OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,206,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5024.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5024.25,5024.25,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,207,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,37994,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,37994,37994,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,208,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14870.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14870.9,14870.9,
CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,212,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,59238.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,59238.85,59238.85,
OTHER HEART ASSIST SYSTEM IMPLANT,215,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,56181.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,56181.4,56181.4,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,216,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,53379.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,53379.15,53379.15,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,217,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,35009.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,35009.15,35009.15,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,218,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,31331.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,31331.85,31331.85,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,219,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,42411.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,42411.6,42411.6,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,220,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28845.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28845.3,28845.3,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,221,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,25567.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,25567.3,25567.3,
OTHER CARDIOTHORACIC PROCEDURES WITH MCC,228,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27712.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27712.85,27712.85,
OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,229,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17487.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17487.8,17487.8,
CORONARY BYPASS WITH PTCA WITH MCC,231,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,44633.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,44633.6,44633.6,
CORONARY BYPASS WITH PTCA WITHOUT MCC,232,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,32717.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,32717.3,32717.3,
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,233,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,42897.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,42897.8,42897.8,
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,234,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28588.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28588.45,28588.45,
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,235,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,32343.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,32343.3,32343.3,
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,236,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22226.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22226.6,22226.6,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,239,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26437.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26437.4,26437.4,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,240,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15450.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15450.6,15450.6,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,241,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7643.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7643.9,7643.9,
PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,242,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19003.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19003.05,19003.05,
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,243,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12526.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12526.8,12526.8,
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,244,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10062.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10062.25,10062.25,
AICD GENERATOR PROCEDURES,245,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24922.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24922.7,24922.7,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,250,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12929.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12929.4,12929.4,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,251,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8727.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8727.95,8727.95,
OTHER VASCULAR PROCEDURES WITH MCC,252,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18445.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18445.9,18445.9,
OTHER VASCULAR PROCEDURES WITH CC,253,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14031.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14031.05,14031.05,
OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,254,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9543.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9543.05,9543.05,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,255,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15110.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15110.7,15110.7,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,256,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9018.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9018.35,9018.35,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,257,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5450.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5450.5,5450.5,
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,258,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14897.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14897.3,14897.3,
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,259,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10266.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10266.3,10266.3,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,260,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18233.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18233.6,18233.6,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,261,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10349.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10349.9,10349.9,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,262,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9049.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9049.15,9049.15,
VEIN LIGATION AND STRIPPING,263,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15538.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15538.6,15538.6,
OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,264,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17963,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17963,17963,
AICD LEAD PROCEDURES,265,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19437.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19437.55,19437.55,
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,266,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,34353.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,34353.55,34353.55,
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,267,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26841.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26841.1,26841.1,
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,268,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,37700.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,37700.85,37700.85,
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,269,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22872.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22872.3,22872.3,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,270,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27812.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27812.95,27812.95,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,271,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19009.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19009.1,19009.1,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,272,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13417.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13417.25,13417.25,
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,273,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21433.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21433.5,21433.5,
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,274,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17824.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17824.4,17824.4,
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,275,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,38696.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,38696.9,38696.9,
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC,276,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,34156.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,34156.1,34156.1,
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,277,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26303.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26303.2,26303.2,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,278,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24532.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24532.2,24532.2,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,279,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17603.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17603.3,17603.3,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",280,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8725.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8725.75,8725.75,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",281,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5021.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5021.5,5021.5,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",282,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3949.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3949.55,3949.55,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",283,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10842.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10842.7,10842.7,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",284,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4068.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4068.35,4068.35,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",285,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,2687.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,2687.85,2687.85,
"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",286,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11855.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11855.8,11855.8,
"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",287,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5948.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5948.8,5948.8,
ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,288,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14261.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14261.5,14261.5,
ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,289,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8127.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8127.35,8127.35,
ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,290,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5638.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5638.6,5638.6,
HEART FAILURE AND SHOCK WITH MCC,291,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7061.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7061.45,7061.45,
HEART FAILURE AND SHOCK WITH CC,292,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4710.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4710.75,4710.75,
HEART FAILURE AND SHOCK WITHOUT CC/MCC,293,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3088.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3088.25,3088.25,
DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,294,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6015.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6015.35,6015.35,
DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,295,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3473.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3473.25,3473.25,
"CARDIAC ARREST, UNEXPLAINED WITH MCC",296,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8817.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8817.6,8817.6,
"CARDIAC ARREST, UNEXPLAINED WITH CC",297,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4007.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4007.3,4007.3,
"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",298,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,2413.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,2413.95,2413.95,
PERIPHERAL VASCULAR DISORDERS WITH MCC,299,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8669.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8669.1,8669.1,
PERIPHERAL VASCULAR DISORDERS WITH CC,300,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5868.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5868.5,5868.5,
PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,301,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3903.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3903.9,3903.9,
ATHEROSCLEROSIS WITH MCC,302,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6166.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6166.05,6166.05,
ATHEROSCLEROSIS WITHOUT MCC,303,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3619.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3619.55,3619.55,
HYPERTENSION WITH MCC,304,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6319.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6319.5,6319.5,
HYPERTENSION WITHOUT MCC,305,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4144.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4144.25,4144.25,
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,306,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8452.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8452.4,8452.4,
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,307,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5184.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5184.3,5184.3,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,308,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6612.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6612.1,6612.1,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,309,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4095.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4095.85,4095.85,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,310,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3041.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3041.5,3041.5,
ANGINA PECTORIS,311,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3839.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3839.55,3839.55,
SYNCOPE AND COLLAPSE,312,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4749.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4749.25,4749.25,
CHEST PAIN,313,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3979.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3979.8,3979.8,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,314,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11514.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11514.25,11514.25,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,315,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5320.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5320.15,5320.15,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,316,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3809.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3809.85,3809.85,
OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,319,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23990.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23990.45,23990.45,
OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,320,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12243,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12243,12243,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,321,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15810.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15810.85,15810.85,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,322,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10028.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10028.7,10028.7,
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,323,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22770,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22770,22770,
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,324,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16327.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16327.3,16327.3,
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,325,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14543.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14543.65,14543.65,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",326,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27934.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27934.5,27934.5,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",327,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13735.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13735.7,13735.7,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",328,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8785.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8785.15,8785.15,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,329,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24842.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24842.4,24842.4,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,330,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13046.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13046.55,13046.55,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,331,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9196,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9196,9196,
RECTAL RESECTION WITH MCC,332,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19951.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19951.8,19951.8,
RECTAL RESECTION WITH CC,333,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11437.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11437.25,11437.25,
RECTAL RESECTION WITHOUT CC/MCC,334,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8828.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8828.05,8828.05,
PERITONEAL ADHESIOLYSIS WITH MCC,335,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19662.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19662.5,19662.5,
PERITONEAL ADHESIOLYSIS WITH CC,336,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11579.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11579.15,11579.15,
PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,337,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8230.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8230.2,8230.2,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,344,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15072.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15072.2,15072.2,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,345,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8473.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8473.3,8473.3,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,346,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7082.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7082.9,7082.9,
ANAL AND STOMAL PROCEDURES WITH MCC,347,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14020.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14020.05,14020.05,
ANAL AND STOMAL PROCEDURES WITH CC,348,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7157.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7157.7,7157.7,
ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,349,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5366.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5366.9,5366.9,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,350,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13200,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13200,13200,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,351,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8005.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8005.8,8005.8,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,352,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6099.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6099.5,6099.5,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,353,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16083.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16083.65,16083.65,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,354,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9447.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9447.9,9447.9,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,355,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7494.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7494.3,7494.3,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,356,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23532.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23532.85,23532.85,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,357,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12082.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12082.4,12082.4,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,358,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7046.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7046.05,7046.05,
MAJOR ESOPHAGEAL DISORDERS WITH MCC,368,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9086,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9086,9086,
MAJOR ESOPHAGEAL DISORDERS WITH CC,369,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5435.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5435.65,5435.65,
MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,370,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4090.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4090.35,4090.35,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,371,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9612.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9612.35,9612.35,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,372,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5732.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5732.65,5732.65,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,373,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3940.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3940.75,3940.75,
DIGESTIVE MALIGNANCY WITH MCC,374,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11544.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11544.5,11544.5,
DIGESTIVE MALIGNANCY WITH CC,375,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6590.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6590.65,6590.65,
DIGESTIVE MALIGNANCY WITHOUT CC/MCC,376,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4902.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4902.7,4902.7,
GASTROINTESTINAL HEMORRHAGE WITH MCC,377,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9846.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9846.65,9846.65,
GASTROINTESTINAL HEMORRHAGE WITH CC,378,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5410.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5410.9,5410.9,
GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,379,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3482.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3482.6,3482.6,
COMPLICATED PEPTIC ULCER WITH MCC,380,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10716.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10716.75,10716.75,
COMPLICATED PEPTIC ULCER WITH CC,381,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5901.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5901.5,5901.5,
COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,382,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4164.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4164.05,4164.05,
UNCOMPLICATED PEPTIC ULCER WITH MCC,383,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7690.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7690.1,7690.1,
UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,384,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4816.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4816.35,4816.35,
INFLAMMATORY BOWEL DISEASE WITH MCC,385,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8617.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8617.95,8617.95,
INFLAMMATORY BOWEL DISEASE WITH CC,386,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5343.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5343.8,5343.8,
INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,387,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3762.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3762.55,3762.55,
GASTROINTESTINAL OBSTRUCTION WITH MCC,388,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7994.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7994.25,7994.25,
GASTROINTESTINAL OBSTRUCTION WITH CC,389,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4380.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4380.2,4380.2,
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,390,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3074.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3074.5,3074.5,
"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",391,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7016.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7016.35,7016.35,
"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",392,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4320.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4320.8,4320.8,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,393,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8907.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8907.8,8907.8,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,394,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5152.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5152.95,5152.95,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,395,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3561.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3561.25,3561.25,
APPENDIX PROCEDURES WITH MCC,397,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12356.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12356.3,12356.3,
APPENDIX PROCEDURES WITH CC,398,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8323.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8323.15,8323.15,
APPENDIX PROCEDURES WITHOUT CC/MCC,399,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6122.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6122.05,6122.05,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",405,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,30278.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,30278.6,30278.6,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",406,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15880.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15880.7,15880.7,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",407,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11830.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11830.5,11830.5,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,408,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20472.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20472.1,20472.1,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,409,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10765.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10765.15,10765.15,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,410,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8608.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8608.6,8608.6,
CHOLECYSTECTOMY WITH C.D.E. WITH MCC,411,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15842.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15842.75,15842.75,
CHOLECYSTECTOMY WITH C.D.E. WITH CC,412,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11250.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11250.25,11250.25,
CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,413,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8302.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8302.8,8302.8,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,414,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19388.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19388.6,19388.6,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,415,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10866.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10866.9,10866.9,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,416,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7365.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7365.6,7365.6,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,417,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12747.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12747.9,12747.9,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,418,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8990.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8990.85,8990.85,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,419,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7222.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7222.6,7222.6,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,420,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17604.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17604.4,17604.4,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,421,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9402.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9402.8,9402.8,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,422,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7760.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7760.5,7760.5,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,423,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21509.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21509.95,21509.95,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,424,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11480.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11480.15,11480.15,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,425,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8810.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8810.45,8810.45,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,432,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10538,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10538,10538,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,433,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5670.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5670.5,5670.5,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,434,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3682.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3682.25,3682.25,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,435,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9679.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9679.45,9679.45,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,436,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6053.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6053.85,6053.85,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,437,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4571.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4571.05,4571.05,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,438,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9178.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9178.4,9178.4,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,439,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4703.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4703.6,4703.6,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,440,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3385.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3385.8,3385.8,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",441,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10055.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10055.1,10055.1,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",442,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5233.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5233.25,5233.25,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",443,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3930.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3930.85,3930.85,
DISORDERS OF THE BILIARY TRACT WITH MCC,444,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8982.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8982.6,8982.6,
DISORDERS OF THE BILIARY TRACT WITH CC,445,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5977.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5977.4,5977.4,
DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,446,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4408.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4408.25,4408.25,
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC,453,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,48737.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,48737.7,48737.7,
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC,454,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33639.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33639.65,33639.65,
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC,455,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,25330.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,25330.8,25330.8,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",456,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,46361.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,46361.7,46361.7,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",457,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33414.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33414.15,33414.15,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",458,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24920.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24920.5,24920.5,
SPINAL FUSION EXCEPT CERVICAL WITH MCC,459,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,36477.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,36477.65,36477.65,
SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,460,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20118.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20118.45,20118.45,
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,461,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,37501.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,37501.75,37501.75,
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,462,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15654.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15654.65,15654.65,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,463,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,31150.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,31150.35,31150.35,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,464,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16507.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16507.7,16507.7,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,465,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10289.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10289.4,10289.4,
REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,466,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28526.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,28526.3,28526.3,
REVISION OF HIP OR KNEE REPLACEMENT WITH CC,467,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19174.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19174.65,19174.65,
REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,468,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14682.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14682.8,14682.8,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,469,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18313.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18313.9,18313.9,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,470,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10349.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10349.35,10349.35,
CERVICAL SPINAL FUSION WITH MCC,471,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27054.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27054.5,27054.5,
CERVICAL SPINAL FUSION WITH CC,472,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16254.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16254.7,16254.7,
CERVICAL SPINAL FUSION WITHOUT CC/MCC,473,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13533.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13533.3,13533.3,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,474,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23665.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23665.4,23665.4,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,475,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11795.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11795.85,11795.85,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,476,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6472.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6472.95,6472.95,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,477,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18529.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18529.5,18529.5,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,478,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13110.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13110.35,13110.35,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,479,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10252,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10252,10252,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,480,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16218.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16218.95,16218.95,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,481,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11411.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11411.95,11411.95,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,482,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8736.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8736.2,8736.2,
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,483,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13663.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13663.1,13663.1,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,485,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18117,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18117,18117,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,486,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11045.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11045.65,11045.65,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,487,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8496.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8496.95,8496.95,
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,488,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11586.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11586.3,11586.3,
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,489,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6807.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6807.35,6807.35,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",492,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19041.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19041.55,19041.55,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",493,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13209.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13209.35,13209.35,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",494,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10280.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10280.6,10280.6,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,495,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19696.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19696.6,19696.6,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,496,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10931.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10931.25,10931.25,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,497,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7850.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7850.7,7850.7,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,498,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14360.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14360.5,14360.5,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,499,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7093.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7093.9,7093.9,
SOFT TISSUE PROCEDURES WITH MCC,500,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17835.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17835.4,17835.4,
SOFT TISSUE PROCEDURES WITH CC,501,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9546.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9546.35,9546.35,
SOFT TISSUE PROCEDURES WITHOUT CC/MCC,502,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7604.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7604.85,7604.85,
FOOT PROCEDURES WITH MCC,503,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14750.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14750.45,14750.45,
FOOT PROCEDURES WITH CC,504,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9499.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9499.05,9499.05,
FOOT PROCEDURES WITHOUT CC/MCC,505,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9381.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9381.35,9381.35,
MAJOR THUMB OR JOINT PROCEDURES,506,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8044.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8044.3,8044.3,
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,507,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11724.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11724.35,11724.35,
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,508,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7887,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7887,7887,
ARTHROSCOPY,509,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7294.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7294.1,7294.1,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",510,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14963.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14963.3,14963.3,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",511,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10965.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10965.9,10965.9,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",512,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8875.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8875.9,8875.9,
"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",513,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8915.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8915.5,8915.5,
"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",514,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5728.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5728.25,5728.25,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,515,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17388.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17388.25,17388.25,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,516,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11224.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11224.4,11224.4,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,517,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8219.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8219.2,8219.2,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,518,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20084.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20084.9,20084.9,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,519,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10827.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10827.3,10827.3,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,520,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7873.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7873.25,7873.25,
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,521,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16468.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16468.1,16468.1,
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,522,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11617.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11617.1,11617.1,
FRACTURES OF FEMUR WITH MCC,533,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8972.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8972.7,8972.7,
FRACTURES OF FEMUR WITHOUT MCC,534,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4455,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4455,4455,
FRACTURES OF HIP AND PELVIS WITH MCC,535,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7131.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7131.85,7131.85,
FRACTURES OF HIP AND PELVIS WITHOUT MCC,536,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4329.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4329.05,4329.05,
"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",537,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5318.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5318.5,5318.5,
"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",538,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3900.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3900.05,3900.05,
OSTEOMYELITIS WITH MCC,539,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10914.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10914.2,10914.2,
OSTEOMYELITIS WITH CC,540,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7140.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7140.1,7140.1,
OSTEOMYELITIS WITHOUT CC/MCC,541,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4718.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4718.45,4718.45,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,542,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10030.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10030.35,10030.35,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,543,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5998.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5998.85,5998.85,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,544,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4221.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4221.25,4221.25,
CONNECTIVE TISSUE DISORDERS WITH MCC,545,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13712.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13712.6,13712.6,
CONNECTIVE TISSUE DISORDERS WITH CC,546,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6596.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6596.15,6596.15,
CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,547,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4473.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4473.7,4473.7,
SEPTIC ARTHRITIS WITH MCC,548,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10723.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10723.9,10723.9,
SEPTIC ARTHRITIS WITH CC,549,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6634.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6634.1,6634.1,
SEPTIC ARTHRITIS WITHOUT CC/MCC,550,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5064.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5064.4,5064.4,
MEDICAL BACK PROBLEMS WITH MCC,551,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9360.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9360.45,9360.45,
MEDICAL BACK PROBLEMS WITHOUT MCC,552,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5314.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5314.65,5314.65,
BONE DISEASES AND ARTHROPATHIES WITH MCC,553,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7433.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7433.25,7433.25,
BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,554,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4519.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4519.9,4519.9,
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,555,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7694.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7694.5,7694.5,
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,556,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4534.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4534.2,4534.2,
"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",557,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8562.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8562.4,8562.4,
"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",558,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4831.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4831.2,4831.2,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",559,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10177.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10177.75,10177.75,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",560,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6226.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6226.55,6226.55,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",561,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4291.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4291.1,4291.1,
"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",562,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8363.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8363.85,8363.85,
"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",563,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4925.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4925.8,4925.8,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,564,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8590.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8590.45,8590.45,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,565,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5496.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5496.7,5496.7,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,566,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4127.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4127.75,4127.75,
SKIN DEBRIDEMENT WITH MCC,570,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16072.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16072.1,16072.1,
SKIN DEBRIDEMENT WITH CC,571,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9305.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9305.45,9305.45,
SKIN DEBRIDEMENT WITHOUT CC/MCC,572,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6267.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6267.8,6267.8,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,573,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,34199.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,34199.55,34199.55,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,574,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18731.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18731.9,18731.9,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,575,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11253,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11253,11253,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,576,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,31257.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,31257.05,31257.05,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,577,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14570.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14570.05,14570.05,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,578,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8857.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8857.75,8857.75,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",579,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18382.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18382.1,18382.1,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",580,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9606.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9606.3,9606.3,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",581,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7406.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7406.85,7406.85,
MASTECTOMY FOR MALIGNANCY WITH CC/MCC,582,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9169.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9169.05,9169.05,
MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,583,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8370.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8370.45,8370.45,
"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",584,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10772.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10772.3,10772.3,
"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",585,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9262,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9262,9262,
SKIN ULCERS WITH MCC,592,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11495.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11495.55,11495.55,
SKIN ULCERS WITH CC,593,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6654.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6654.45,6654.45,
SKIN ULCERS WITHOUT CC/MCC,594,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4330.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4330.7,4330.7,
MAJOR SKIN DISORDERS WITH MCC,595,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11962.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11962.5,11962.5,
MAJOR SKIN DISORDERS WITHOUT MCC,596,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5549.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5549.5,5549.5,
MALIGNANT BREAST DISORDERS WITH MCC,597,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8802.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8802.75,8802.75,
MALIGNANT BREAST DISORDERS WITH CC,598,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6593.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6593.4,6593.4,
MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,599,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3417.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3417.7,3417.7,
NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,600,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5640.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5640.25,5640.25,
NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,601,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3424.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3424.3,3424.3,
CELLULITIS WITH MCC,602,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8181.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8181.25,8181.25,
CELLULITIS WITHOUT MCC,603,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4865.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4865.85,4865.85,
"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",604,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8284.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8284.1,8284.1,
"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",605,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4998.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4998.4,4998.4,
MINOR SKIN DISORDERS WITH MCC,606,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8721.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8721.9,8721.9,
MINOR SKIN DISORDERS WITHOUT MCC,607,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4914.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4914.25,4914.25,
ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,614,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12388.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12388.2,12388.2,
ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,615,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8091.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8091.05,8091.05,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",616,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21767.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21767.35,21767.35,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",617,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10914.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10914.75,10914.75,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",618,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6388.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6388.25,6388.25,
O.R. PROCEDURES FOR OBESITY WITH MCC,619,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14236.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14236.75,14236.75,
O.R. PROCEDURES FOR OBESITY WITH CC,620,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8922.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8922.1,8922.1,
O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,621,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8345.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8345.15,8345.15,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",622,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21040.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21040.8,21040.8,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",623,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10237.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10237.7,10237.7,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",624,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6129.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6129.75,6129.75,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",625,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16066.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16066.6,16066.6,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",626,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8205.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8205.45,8205.45,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",627,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6798,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6798,6798,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",628,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22079.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22079.75,22079.75,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",629,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12445.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12445.4,12445.4,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",630,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7679.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7679.65,7679.65,
DIABETES WITH MCC,637,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7971.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7971.15,7971.15,
DIABETES WITH CC,638,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4946.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4946.7,4946.7,
DIABETES WITHOUT CC/MCC,639,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3423.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3423.75,3423.75,
"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",640,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7233.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7233.6,7233.6,
"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",641,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4297.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4297.7,4297.7,
INBORN AND OTHER DISORDERS OF METABOLISM,642,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7168.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7168.15,7168.15,
ENDOCRINE DISORDERS WITH MCC,643,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9048.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9048.05,9048.05,
ENDOCRINE DISORDERS WITH CC,644,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5839.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5839.35,5839.35,
ENDOCRINE DISORDERS WITHOUT CC/MCC,645,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4184.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4184.95,4184.95,
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,650,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24736.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24736.25,24736.25,
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,651,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19021.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19021.2,19021.2,
KIDNEY TRANSPLANT,652,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16524.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16524.2,16524.2,
MAJOR BLADDER PROCEDURES WITH MCC,653,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,29774.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,29774.8,29774.8,
MAJOR BLADDER PROCEDURES WITH CC,654,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15056.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15056.25,15056.25,
MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,655,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11592.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11592.9,11592.9,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,656,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17256.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17256.8,17256.8,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,657,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10143.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10143.1,10143.1,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,658,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8142.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8142.2,8142.2,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,659,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14238.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14238.95,14238.95,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,660,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7402.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7402.45,7402.45,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,661,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5766.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5766.2,5766.2,
MINOR BLADDER PROCEDURES WITH MCC,662,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16481.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16481.85,16481.85,
MINOR BLADDER PROCEDURES WITH CC,663,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8024.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8024.5,8024.5,
MINOR BLADDER PROCEDURES WITHOUT CC/MCC,664,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5838.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5838.8,5838.8,
PROSTATECTOMY WITH MCC,665,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16990.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16990.05,16990.05,
PROSTATECTOMY WITH CC,666,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9445.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9445.7,9445.7,
PROSTATECTOMY WITHOUT CC/MCC,667,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5772.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5772.8,5772.8,
TRANSURETHRAL PROCEDURES WITH MCC,668,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15499,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15499,15499,
TRANSURETHRAL PROCEDURES WITH CC,669,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8440.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8440.3,8440.3,
TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,670,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5294.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5294.3,5294.3,
URETHRAL PROCEDURES WITH CC/MCC,671,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9415.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9415.45,9415.45,
URETHRAL PROCEDURES WITHOUT CC/MCC,672,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5074.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5074.85,5074.85,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,673,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20339,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20339,20339,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,674,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13102.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13102.1,13102.1,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,675,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8725.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8725.75,8725.75,
RENAL FAILURE WITH MCC,682,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8254.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8254.4,8254.4,
RENAL FAILURE WITH CC,683,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4954.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4954.4,4954.4,
RENAL FAILURE WITHOUT CC/MCC,684,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3346.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3346.75,3346.75,
KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,686,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10116.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10116.7,10116.7,
KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,687,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5749.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5749.15,5749.15,
KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,688,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4294.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4294.95,4294.95,
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,689,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6459.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6459.2,6459.2,
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,690,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4437.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4437.95,4437.95,
URINARY STONES WITH MCC,693,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7789.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7789.65,7789.65,
URINARY STONES WITHOUT MCC,694,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4304.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4304.85,4304.85,
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,695,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6578,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6578,6578,
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,696,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3806.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3806.55,3806.55,
URETHRAL STRICTURE,697,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6122.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6122.05,6122.05,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,698,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9099.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9099.2,9099.2,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,699,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5614.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5614.4,5614.4,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,700,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3895.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3895.65,3895.65,
MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,707,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10790.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10790.45,10790.45,
MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,708,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8021.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8021.75,8021.75,
PENIS PROCEDURES WITH CC/MCC,709,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11660,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11660,11660,
PENIS PROCEDURES WITHOUT CC/MCC,710,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6788.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6788.65,6788.65,
TESTES PROCEDURES WITH CC/MCC,711,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11675.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11675.95,11675.95,
TESTES PROCEDURES WITHOUT CC/MCC,712,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6536.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6536.2,6536.2,
TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,713,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7978.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7978.85,7978.85,
TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,714,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5271.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5271.75,5271.75,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,715,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12141.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12141.25,12141.25,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,716,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7822.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7822.1,7822.1,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,717,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9975.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9975.35,9975.35,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,718,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6466.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6466.9,6466.9,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",722,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10311.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10311.4,10311.4,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",723,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6128.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6128.65,6128.65,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",724,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4452.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4452.25,4452.25,
BENIGN PROSTATIC HYPERTROPHY WITH MCC,725,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6824.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6824.95,6824.95,
BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,726,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4019.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4019.95,4019.95,
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,727,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8915.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8915.5,8915.5,
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,728,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4400.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4400.55,4400.55,
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,729,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5521.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5521.45,5521.45,
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,730,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3418.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3418.8,3418.8,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",734,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11954.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11954.8,11954.8,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",735,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6931.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6931.1,6931.1,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,736,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21379.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21379.6,21379.6,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,737,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10855.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10855.9,10855.9,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,738,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7505.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7505.3,7505.3,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,739,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19889.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,19889.65,19889.65,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,740,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9828.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9828.5,9828.5,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,741,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7146.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7146.15,7146.15,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,742,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9800.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9800.45,9800.45,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,743,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6391,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6391,6391,
"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",744,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10353.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10353.2,10353.2,
"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",745,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5697.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5697.45,5697.45,
"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",746,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9218.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9218.55,9218.55,
"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",747,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4879.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4879.6,4879.6,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,748,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7726.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7726.95,7726.95,
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,749,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13844.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13844.6,13844.6,
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,750,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7480,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7480,7480,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",754,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10188.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10188.75,10188.75,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",755,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5965.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5965.85,5965.85,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",756,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5443.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5443.35,5443.35,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",757,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8203.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8203.8,8203.8,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",758,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5459.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5459.3,5459.3,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",759,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3554.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3554.1,3554.1,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,760,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5474.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5474.7,5474.7,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,761,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3330.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3330.8,3330.8,
VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,768,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6699.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6699.55,6699.55,
POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,769,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8491.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8491.45,8491.45,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",770,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4392.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4392.85,4392.85,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,776,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3941.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3941.85,3941.85,
ABORTION WITHOUT D&C,779,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5440.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5440.6,5440.6,
CESAREAN SECTION WITH STERILIZATION WITH MCC,783,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9744.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9744.9,9744.9,
CESAREAN SECTION WITH STERILIZATION WITH CC,784,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5632.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5632.55,5632.55,
CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,785,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4764.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4764.65,4764.65,
CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,786,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9622.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9622.25,9622.25,
CESAREAN SECTION WITHOUT STERILIZATION WITH CC,787,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5781.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5781.05,5781.05,
CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,788,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4702.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4702.5,4702.5,
"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",789,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10006.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10006.7,10006.7,
"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",790,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33000.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33000.55,33000.55,
PREMATURITY WITH MAJOR PROBLEMS,791,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22537.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22537.35,22537.35,
PREMATURITY WITHOUT MAJOR PROBLEMS,792,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13598.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13598.75,13598.75,
FULL TERM NEONATE WITH MAJOR PROBLEMS,793,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23151.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23151.15,23151.15,
NEONATE WITH OTHER SIGNIFICANT PROBLEMS,794,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8194.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8194.45,8194.45,
NORMAL NEWBORN,795,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,1109.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,1109.35,1109.35,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,796,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7801.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7801.2,7801.2,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,797,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5477.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5477.45,5477.45,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,798,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4461.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4461.6,4461.6,
SPLENIC PROCEDURES WITH MCC,799,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27250.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27250.3,27250.3,
SPLENIC PROCEDURES WITH CC,800,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15497.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15497.35,15497.35,
SPLENIC PROCEDURES WITHOUT CC/MCC,801,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9843.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9843.35,9843.35,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,802,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18646.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18646.65,18646.65,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,803,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10220.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10220.1,10220.1,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,804,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6657.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6657.2,6657.2,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,805,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5545.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5545.1,5545.1,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,806,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4106.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4106.85,4106.85,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,807,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3598.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3598.65,3598.65,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,808,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12045.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12045.55,12045.55,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,809,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6624.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6624.2,6624.2,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,810,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5524.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5524.75,5524.75,
RED BLOOD CELL DISORDERS WITH MCC,811,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7719.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7719.8,7719.8,
RED BLOOD CELL DISORDERS WITHOUT MCC,812,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4953.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4953.85,4953.85,
COAGULATION DISORDERS,813,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8580,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8580,8580,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,814,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11704.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11704.55,11704.55,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,815,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5468.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5468.1,5468.1,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,816,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3906.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3906.1,3906.1,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,817,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12402.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12402.5,12402.5,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,818,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6452.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6452.05,6452.05,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,819,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4989.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4989.6,4989.6,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,820,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33256.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33256.85,33256.85,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,821,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12276.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12276.55,12276.55,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,822,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6813.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6813.4,6813.4,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,823,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24760.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24760.45,24760.45,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,824,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12280.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12280.95,12280.95,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,825,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7102.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7102.7,7102.7,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,826,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24138.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24138.4,24138.4,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,827,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12744.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12744.6,12744.6,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,828,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,555500,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,555500,555500,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,829,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17345.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17345.9,17345.9,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,830,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8696.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8696.6,8696.6,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,831,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5553.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5553.9,5553.9,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,832,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4057.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4057.35,4057.35,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,833,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,2814.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,2814.9,2814.9,
ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC,834,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,30794.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,30794.5,30794.5,
ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC,835,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12295.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,12295.25,12295.25,
ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC,836,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6585.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6585.15,6585.15,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,837,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26161.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26161.3,26161.3,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,838,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10738.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10738.2,10738.2,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,839,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7167.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7167.05,7167.05,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,840,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17188.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17188.6,17188.6,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,841,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8654.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8654.25,8654.25,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,842,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5865.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5865.2,5865.2,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,843,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10233.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10233.3,10233.3,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,844,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6364.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6364.6,6364.6,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,845,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4756.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4756.95,4756.95,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,846,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13442,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13442,13442,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,847,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6669.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6669.3,6669.3,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,848,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4177.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4177.25,4177.25,
RADIOTHERAPY,849,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14802.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,14802.7,14802.7,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,853,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27496.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,27496.15,27496.15,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,854,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11210.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11210.1,11210.1,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,855,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9359.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9359.9,9359.9,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,856,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24356.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,24356.2,24356.2,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,857,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11746.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11746.35,11746.35,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,858,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7058.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7058.7,7058.7,
POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,862,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10131,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10131,10131,
POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,863,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5530.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5530.25,5530.25,
FEVER AND INFLAMMATORY CONDITIONS,864,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4855.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4855.4,4855.4,
VIRAL ILLNESS WITH MCC,865,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9019.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9019.45,9019.45,
VIRAL ILLNESS WITHOUT MCC,866,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5047.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5047.35,5047.35,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,867,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11507.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11507.65,11507.65,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,868,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5970.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5970.25,5970.25,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,869,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3798.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3798.85,3798.85,
SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,870,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,38306.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,38306.95,38306.95,
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,7,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10904.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10904.3,10904.3,
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,872,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5664.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5664.45,5664.45,
O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,876,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20523.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20523.25,20523.25,
ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,880,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5250.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5250.3,5250.3,
DEPRESSIVE NEUROSES,881,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4985.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4985.75,4985.75,
NEUROSES EXCEPT DEPRESSIVE,882,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5166.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5166.15,5166.15,
DISORDERS OF PERSONALITY AND IMPULSE CONTROL,883,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10314.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10314.7,10314.7,
ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,884,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9662.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9662.95,9662.95,
PSYCHOSES,885,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7515.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7515.2,7515.2,
BEHAVIORAL AND DEVELOPMENTAL DISORDERS,886,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9249.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9249.35,9249.35,
OTHER MENTAL DISORDER DIAGNOSES,887,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7125.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7125.8,7125.8,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",894,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3159.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3159.75,3159.75,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",895,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8848.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8848.4,8848.4,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",896,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9779.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9779.55,9779.55,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",897,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4705.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4705.8,4705.8,
WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,901,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23802.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,23802.9,23802.9,
WOUND DEBRIDEMENTS FOR INJURIES WITH CC,902,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10365.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10365.85,10365.85,
WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,903,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6828.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6828.25,6828.25,
SKIN GRAFTS FOR INJURIES WITH CC/MCC,904,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17909.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17909.1,17909.1,
SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,905,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8710.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8710.35,8710.35,
HAND PROCEDURES FOR INJURIES,906,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10348.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10348.8,10348.8,
OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,907,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20457.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,20457.25,20457.25,
OTHER O.R. PROCEDURES FOR INJURIES WITH CC,908,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11022.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11022.55,11022.55,
OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,909,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7459.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7459.65,7459.65,
TRAUMATIC INJURY WITH MCC,913,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8219.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8219.75,8219.75,
TRAUMATIC INJURY WITHOUT MCC,914,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4992.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4992.35,4992.35,
ALLERGIC REACTIONS WITH MCC,915,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9757,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9757,9757,
ALLERGIC REACTIONS WITHOUT MCC,916,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3623.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3623.4,3623.4,
POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,917,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8777.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8777.45,8777.45,
POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,918,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4734.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4734.95,4734.95,
COMPLICATIONS OF TREATMENT WITH MCC,919,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10035.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10035.85,10035.85,
COMPLICATIONS OF TREATMENT WITH CC,920,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5685.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5685.9,5685.9,
COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,921,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3837.9,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3837.9,3837.9,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",922,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9596.95,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9596.95,9596.95,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",923,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5562.7,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5562.7,5562.7,
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,927,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,144972.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,144972.85,144972.85,
FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,928,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,38058.35,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,38058.35,38058.35,
FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,929,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17685.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17685.25,17685.25,
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,933,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16676,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16676,16676,
FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,934,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11508.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11508.75,11508.75,
NON-EXTENSIVE BURNS,935,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11226.05,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11226.05,11226.05,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,939,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17684.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,17684.15,17684.15,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,940,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11916.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,11916.3,11916.3,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,941,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10208,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,10208,10208,
REHABILITATION WITH CC/MCC,945,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8302.25,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8302.25,8302.25,
REHABILITATION WITHOUT CC/MCC,946,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5569.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5569.85,5569.85,
SIGNS AND SYMPTOMS WITH MCC,947,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6883.8,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,6883.8,6883.8,
SIGNS AND SYMPTOMS WITHOUT MCC,948,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4405.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4405.5,4405.5,
AFTERCARE WITH CC/MCC,949,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5698.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5698.55,5698.55,
AFTERCARE WITHOUT CC/MCC,950,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3455.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3455.1,3455.1,
OTHER FACTORS INFLUENCING HEALTH STATUS,951,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3245,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,3245,3245,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,955,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33496.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,33496.1,33496.1,
"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",956,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21330.1,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,21330.1,21330.1,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,957,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,39778.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,39778.75,39778.75,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,958,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22246.4,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,22246.4,22246.4,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,959,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13928.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13928.2,13928.2,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,963,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15038.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,15038.65,15038.65,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,964,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8255.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8255.5,8255.5,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,965,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5257.45,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5257.45,5257.45,
HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,969,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,37799.3,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,37799.3,37799.3,
HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,970,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13224.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13224.2,13224.2,
HIV WITH MAJOR RELATED CONDITION WITH MCC,974,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16040.75,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,16040.75,16040.75,
HIV WITH MAJOR RELATED CONDITION WITH CC,975,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7498.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7498.15,7498.15,
HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,976,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4649.15,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,4649.15,4649.15,
HIV WITH OR WITHOUT OTHER RELATED CONDITION,977,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7788.55,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,7788.55,7788.55,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,981,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26072.2,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,26072.2,26072.2,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,982,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13673,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,13673,13673,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,983,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8993.6,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,8993.6,8993.6,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,987,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18571.85,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,18571.85,18571.85,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,988,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9333.5,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,9333.5,9333.5,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,989,MS-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5941.65,100,MS-DRG,,other,100% of UHC DRG rate using CMS weights and UHC base rate of 5500,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,,,,,other,Not reimbursable at MS-DRG per contract terms,5941.65,5941.65,
LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,11,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21529.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21529.33,21529.33,
LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,12,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24606.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24606.27,24606.27,
LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,13,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30585.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30585.97,30585.97,
LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,14,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,65670.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,65670.88,65670.88,
HEART AND/OR LUNG TRANSPLANT,21,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40073.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40073.98,40073.98,
HEART AND/OR LUNG TRANSPLANT,22,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46008.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46008.8,46008.8,
HEART AND/OR LUNG TRANSPLANT,23,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,57916.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,57916.9,57916.9,
HEART AND/OR LUNG TRANSPLANT,24,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,106702.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,106702.35,106702.35,
TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,41,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22023.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22023.4,22023.4,
TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,42,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28463.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28463.32,28463.32,
TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,43,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41058.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41058.55,41058.55,
TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,44,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62134.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62134.42,62134.42,
TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,51,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14806.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14806.58,14806.58,
TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,52,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21778.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21778.32,21778.32,
TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,53,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29037.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29037.88,29037.88,
TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,54,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40138.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40138.46,40138.46,
PANCREAS TRANSPLANT,61,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19550.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19550.23,19550.23,
PANCREAS TRANSPLANT,62,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28271.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28271.32,28271.32,
PANCREAS TRANSPLANT,63,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,32344.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,32344.94,32344.94,
PANCREAS TRANSPLANT,64,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50401.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50401.22,50401.22,
ALLOGENEIC BONE MARROW TRANSPLANT,71,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22704.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22704.11,22704.11,
ALLOGENEIC BONE MARROW TRANSPLANT,72,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29576.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29576.83,29576.83,
ALLOGENEIC BONE MARROW TRANSPLANT,73,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37296.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37296.26,37296.26,
ALLOGENEIC BONE MARROW TRANSPLANT,74,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73797.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73797.09,73797.09,
AUTOLOGOUS BONE MARROW TRANSPLANT,81,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13720.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13720.14,13720.14,
AUTOLOGOUS BONE MARROW TRANSPLANT,82,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16803.49,16803.49,
AUTOLOGOUS BONE MARROW TRANSPLANT,83,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19891.12,19891.12,
AUTOLOGOUS BONE MARROW TRANSPLANT,84,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36982.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36982.79,36982.79,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),91,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,19330.45,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),92,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19330.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19330.45,19330.45,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),93,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31196.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31196.52,31196.52,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),94,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,69552.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,69552.85,69552.85,
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,111,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19255.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19255.64,19255.64,
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,112,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33859.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33859.9,33859.9,
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,113,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,48723.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,48723.47,48723.47,
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,114,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,85742.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,85742.95,85742.95,
OPEN CRANIOTOMY FOR TRAUMA,201,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.41,7916.41,
OPEN CRANIOTOMY FOR TRAUMA,202,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9338.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9338.4,9338.4,
OPEN CRANIOTOMY FOR TRAUMA,203,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13121.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13121.35,13121.35,
OPEN CRANIOTOMY FOR TRAUMA,204,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21981.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21981.72,21981.72,
OPEN CRANIOTOMY EXCEPT TRAUMA,211,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7532.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7532.77,7532.77,
OPEN CRANIOTOMY EXCEPT TRAUMA,212,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9826.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9826.05,9826.05,
OPEN CRANIOTOMY EXCEPT TRAUMA,213,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15006.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15006.06,15006.06,
OPEN CRANIOTOMY EXCEPT TRAUMA,214,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25609.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25609.01,25609.01,
VENTRICULAR SHUNT PROCEDURES,221,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4790.31,4790.31,
VENTRICULAR SHUNT PROCEDURES,222,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6076.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6076.94,6076.94,
VENTRICULAR SHUNT PROCEDURES,223,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9625.51,9625.51,
VENTRICULAR SHUNT PROCEDURES,224,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20976.85,20976.85,
SPINAL PROCEDURES,231,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6289.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6289.96,6289.96,
SPINAL PROCEDURES,232,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8344.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8344.58,8344.58,
SPINAL PROCEDURES,233,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13916.41,13916.41,
SPINAL PROCEDURES,234,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23454.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23454.29,23454.29,
OPEN EXTRACRANIAL VASCULAR PROCEDURES,241,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3430.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3430.3,3430.3,
OPEN EXTRACRANIAL VASCULAR PROCEDURES,242,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4628.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4628.59,4628.59,
OPEN EXTRACRANIAL VASCULAR PROCEDURES,243,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8468.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8468.18,8468.18,
OPEN EXTRACRANIAL VASCULAR PROCEDURES,244,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15304.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15304.92,15304.92,
OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,261,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4891.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4891.12,4891.12,
OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,262,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6536.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6536.1,6536.1,
OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,263,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9619.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9619.09,9619.09,
OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,264,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19316.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19316.56,19316.56,
OTHER OPEN CRANIOTOMY,271,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6366.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6366.54,6366.54,
OTHER OPEN CRANIOTOMY,272,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7803.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7803.85,7803.85,
OTHER OPEN CRANIOTOMY,273,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13555.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13555.22,13555.22,
OTHER OPEN CRANIOTOMY,274,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22599.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22599.74,22599.74,
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,291,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,7713.02,
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,292,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,7713.02,
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,293,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10130.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10130.61,10130.61,
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,294,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17481.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17481.36,17481.36,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,301,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.41,7153.41,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,302,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9904.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9904.42,9904.42,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,303,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13337.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13337.57,13337.57,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,304,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18542.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18542.51,18542.51,
SPINAL DISORDERS AND INJURIES,401,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3692.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3692.83,3692.83,
SPINAL DISORDERS AND INJURIES,402,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5046.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5046.43,5046.43,
SPINAL DISORDERS AND INJURIES,403,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.08,7361.08,
SPINAL DISORDERS AND INJURIES,404,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10933.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10933.87,10933.87,
NERVOUS SYSTEM MALIGNANCY,411,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2997.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2997.51,2997.51,
NERVOUS SYSTEM MALIGNANCY,412,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3234.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3234.74,3234.74,
NERVOUS SYSTEM MALIGNANCY,413,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4388.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4388.51,4388.51,
NERVOUS SYSTEM MALIGNANCY,414,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7016.62,7016.62,
DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,421,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2574.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2574.69,2574.69,
DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,422,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3172.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3172.05,3172.05,
DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,423,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4669.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4669.91,4669.91,
DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,424,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9098.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9098.32,9098.32,
"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",431,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3279.27,3279.27,
"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",432,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4527.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4527.43,4527.43,
"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",433,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7158.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7158.75,7158.75,
"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",434,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14102.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14102.35,14102.35,
INTRACRANIAL HEMORRHAGE,441,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.77,3141.77,
INTRACRANIAL HEMORRHAGE,442,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4182.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4182.62,4182.62,
INTRACRANIAL HEMORRHAGE,443,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5977.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5977.56,5977.56,
INTRACRANIAL HEMORRHAGE,444,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7544.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7544.88,7544.88,
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,451,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2741.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2741.04,2741.04,
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,452,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3523.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3523.27,3523.27,
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,453,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4938.85,4938.85,
CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,454,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8308.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8308.95,8308.95,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,461,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2713.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2713.96,2713.96,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,462,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3225.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3225.84,3225.84,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,463,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4085.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4085.73,4085.73,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,464,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7992.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7992.64,7992.64,
TRANSIENT ISCHEMIA,471,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2528.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2528.73,2528.73,
TRANSIENT ISCHEMIA,472,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2824.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2824.39,2824.39,
TRANSIENT ISCHEMIA,473,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3504.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3504.39,3504.39,
TRANSIENT ISCHEMIA,474,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6490.5,6490.5,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",481,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.56,2484.56,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",482,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2810.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2810.5,2810.5,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",483,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.97,3829.97,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",484,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7590.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7590.12,7590.12,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,491,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3593.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3593.45,3593.45,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,492,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7354.31,7354.31,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,493,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8573.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8573.62,8573.62,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,494,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.26,14412.26,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,501,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2512.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2512.35,2512.35,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,502,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4927.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4927.1,4927.1,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,503,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7824.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7824.87,7824.87,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,504,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16670.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16670.98,16670.98,
VIRAL MENINGITIS,511,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1782.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1782.47,1782.47,
VIRAL MENINGITIS,512,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,2647.71,
VIRAL MENINGITIS,513,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4513.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4513.89,4513.89,
VIRAL MENINGITIS,514,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10828.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10828.43,10828.43,
ALTERATION IN CONSCIOUSNESS,521,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2268.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2268.35,2268.35,
ALTERATION IN CONSCIOUSNESS,522,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2538.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2538.71,2538.71,
ALTERATION IN CONSCIOUSNESS,523,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3303.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3303.49,3303.49,
ALTERATION IN CONSCIOUSNESS,524,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6963.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6963.55,6963.55,
SEIZURE,531,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2082.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2082.05,2082.05,
SEIZURE,532,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2535.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2535.15,2535.15,
SEIZURE,533,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3412.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3412.14,3412.14,
SEIZURE,534,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8034.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8034.32,8034.32,
MIGRAINE AND OTHER HEADACHES,541,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2255.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2255.88,2255.88,
MIGRAINE AND OTHER HEADACHES,542,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2664.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2664.45,2664.45,
MIGRAINE AND OTHER HEADACHES,543,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,3396.11,
MIGRAINE AND OTHER HEADACHES,544,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5482.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5482.43,5482.43,
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,551,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2638.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2638.45,2638.45,
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,552,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3631.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3631.2,3631.2,
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,553,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5559.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5559.01,5559.01,
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,554,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10453.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10453.69,10453.69,
"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",561,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2468.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2468.54,2468.54,
"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",562,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3531.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3531.82,3531.82,
"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",563,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4805.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4805.63,4805.63,
"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA",564,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8292.21,8292.21,
"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",571,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.51,2395.51,
"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",572,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3328.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3328.78,3328.78,
"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",573,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4912.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4912.49,4912.49,
"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA",574,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8300.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8300.05,8300.05,
OTHER DISORDERS OF NERVOUS SYSTEM,581,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3141.06,3141.06,
OTHER DISORDERS OF NERVOUS SYSTEM,582,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4148.07,4148.07,
OTHER DISORDERS OF NERVOUS SYSTEM,583,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5431.49,5431.49,
OTHER DISORDERS OF NERVOUS SYSTEM,584,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7881.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7881.15,7881.15,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE,591,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2506.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2506.65,2506.65,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE,592,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3640.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3640.82,3640.82,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE,593,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5726.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5726.43,5726.43,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE,594,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7916.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7916.77,7916.77,
ORBIT AND EYE PROCEDURES,731,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3733.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3733.79,3733.79,
ORBIT AND EYE PROCEDURES,732,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4941.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4941.7,4941.7,
ORBIT AND EYE PROCEDURES,733,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7604.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7604.73,7604.73,
ORBIT AND EYE PROCEDURES,734,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.28,16229.28,
EYE INFECTIONS AND OTHER EYE DISORDERS,821,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.66,2231.66,
EYE INFECTIONS AND OTHER EYE DISORDERS,822,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2728.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2728.57,2728.57,
EYE INFECTIONS AND OTHER EYE DISORDERS,823,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4198.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4198.29,4198.29,
EYE INFECTIONS AND OTHER EYE DISORDERS,824,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9079.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9079.79,9079.79,
MAJOR CRANIAL OR FACIAL BONE PROCEDURES,891,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6390.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6390.76,6390.76,
MAJOR CRANIAL OR FACIAL BONE PROCEDURES,892,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8656.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8656.97,8656.97,
MAJOR CRANIAL OR FACIAL BONE PROCEDURES,893,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14978.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14978.63,14978.63,
MAJOR CRANIAL OR FACIAL BONE PROCEDURES,894,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20973.29,20973.29,
OTHER MAJOR HEAD AND NECK PROCEDURES,911,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5609.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5609.6,5609.6,
OTHER MAJOR HEAD AND NECK PROCEDURES,912,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,8660.53,
OTHER MAJOR HEAD AND NECK PROCEDURES,913,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14816.2,14816.2,
OTHER MAJOR HEAD AND NECK PROCEDURES,914,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22802.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22802.43,22802.43,
FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,921,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5020.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5020.07,5020.07,
FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,922,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6699.24,6699.24,
FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,923,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10944.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10944.55,10944.55,
FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,924,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21833.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21833.54,21833.54,
CLEFT LIP AND PALATE REPAIR,951,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3065.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3065.54,3065.54,
CLEFT LIP AND PALATE REPAIR,952,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3566.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3566.02,3566.02,
CLEFT LIP AND PALATE REPAIR,953,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6405.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6405.72,6405.72,
CLEFT LIP AND PALATE REPAIR,954,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10803.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10803.49,10803.49,
TONSIL AND ADENOID PROCEDURES,971,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2192.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2192.47,2192.47,
TONSIL AND ADENOID PROCEDURES,972,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3213.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3213.37,3213.37,
TONSIL AND ADENOID PROCEDURES,973,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5129.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5129.42,5129.42,
TONSIL AND ADENOID PROCEDURES,974,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,11326.41,
"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES",981,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.62,3336.62,
"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES",982,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4728.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4728.33,4728.33,
"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES",983,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7874.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7874.38,7874.38,
"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES",984,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13999.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13999.41,13999.41,
"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",1101,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2988.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2988.96,2988.96,
"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",1102,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3433.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3433.51,3433.51,
"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",1103,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5212.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5212.78,5212.78,
"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",1104,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8764.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8764.19,8764.19,
VERTIGO AND OTHER LABYRINTH DISORDERS,1111,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2196.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2196.39,2196.39,
VERTIGO AND OTHER LABYRINTH DISORDERS,1112,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2431.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2431.49,2431.49,
VERTIGO AND OTHER LABYRINTH DISORDERS,1113,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2985.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2985.04,2985.04,
VERTIGO AND OTHER LABYRINTH DISORDERS,1114,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5568.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5568.27,5568.27,
INFECTIONS OF UPPER RESPIRATORY TRACT,1131,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1329.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1329.02,1329.02,
INFECTIONS OF UPPER RESPIRATORY TRACT,1132,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.16,1876.16,
INFECTIONS OF UPPER RESPIRATORY TRACT,1133,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2627.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2627.4,2627.4,
INFECTIONS OF UPPER RESPIRATORY TRACT,1134,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4605.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4605.08,4605.08,
DENTAL DISEASES AND DISORDERS,1141,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1526.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1526.36,1526.36,
DENTAL DISEASES AND DISORDERS,1142,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,2168.96,
DENTAL DISEASES AND DISORDERS,1143,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3689.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3689.62,3689.62,
DENTAL DISEASES AND DISORDERS,1144,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5720.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5720.38,5720.38,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",1151,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1916.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1916.41,1916.41,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",1152,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2612.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2612.09,2612.09,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",1153,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3930.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3930.06,3930.06,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",1154,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7409.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7409.17,7409.17,
MAJOR RESPIRATORY AND CHEST PROCEDURES,1201,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6278.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6278.56,6278.56,
MAJOR RESPIRATORY AND CHEST PROCEDURES,1202,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7832.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7832.7,7832.7,
MAJOR RESPIRATORY AND CHEST PROCEDURES,1203,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11542.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11542.63,11542.63,
MAJOR RESPIRATORY AND CHEST PROCEDURES,1204,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22147,22147,
OTHER RESPIRATORY AND CHEST PROCEDURES,1211,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4865.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4865.12,4865.12,
OTHER RESPIRATORY AND CHEST PROCEDURES,1212,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6451.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6451.68,6451.68,
OTHER RESPIRATORY AND CHEST PROCEDURES,1213,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10287.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10287.34,10287.34,
OTHER RESPIRATORY AND CHEST PROCEDURES,1214,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18009.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18009.98,18009.98,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,1301,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11669.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11669.08,11669.08,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,1302,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11942.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11942.3,11942.3,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,1303,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14918.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14918.43,14918.43,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,1304,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20015.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20015.44,20015.44,
CYSTIC FIBROSIS - PULMONARY DISEASE,1311,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.8,4413.8,
CYSTIC FIBROSIS - PULMONARY DISEASE,1312,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6144.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6144.27,6144.27,
CYSTIC FIBROSIS - PULMONARY DISEASE,1313,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8146.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8146.17,8146.17,
CYSTIC FIBROSIS - PULMONARY DISEASE,1314,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11245.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11245.19,11245.19,
BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,1321,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.16,1658.16,
BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,1322,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,2245.55,
BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,1323,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3885.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3885.89,3885.89,
BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,1324,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6387.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6387.2,6387.2,
RESPIRATORY FAILURE,1331,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1708.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1708.38,1708.38,
RESPIRATORY FAILURE,1332,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2602.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2602.11,2602.11,
RESPIRATORY FAILURE,1333,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3978.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3978.51,3978.51,
RESPIRATORY FAILURE,1334,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6987.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6987.06,6987.06,
PULMONARY EMBOLISM,1341,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2015.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2015.08,2015.08,
PULMONARY EMBOLISM,1342,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2684.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2684.4,2684.4,
PULMONARY EMBOLISM,1343,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4003.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4003.8,4003.8,
PULMONARY EMBOLISM,1344,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6251.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6251.84,6251.84,
MAJOR CHEST AND RESPIRATORY TRAUMA,1351,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.74,2689.74,
MAJOR CHEST AND RESPIRATORY TRAUMA,1352,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3149.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3149.97,3149.97,
MAJOR CHEST AND RESPIRATORY TRAUMA,1353,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4460.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4460.46,4460.46,
MAJOR CHEST AND RESPIRATORY TRAUMA,1354,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7454.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7454.05,7454.05,
RESPIRATORY MALIGNANCY,1361,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2623.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2623.84,2623.84,
RESPIRATORY MALIGNANCY,1362,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3405.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3405.37,3405.37,
RESPIRATORY MALIGNANCY,1363,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4817.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4817.03,4817.03,
RESPIRATORY MALIGNANCY,1364,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7161.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7161.96,7161.96,
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,1371,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2213.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2213.49,2213.49,
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,1372,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2788.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2788.77,2788.77,
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,1373,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3963.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3963.9,3963.9,
MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,1374,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6179.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6179.89,6179.89,
BRONCHIOLITIS AND RSV PNEUMONIA,1381,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1215.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1215.39,1215.39,
BRONCHIOLITIS AND RSV PNEUMONIA,1382,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.31,1764.31,
BRONCHIOLITIS AND RSV PNEUMONIA,1383,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,2805.51,
BRONCHIOLITIS AND RSV PNEUMONIA,1384,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6123.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6123.61,6123.61,
OTHER PNEUMONIA,1391,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1611.49,1611.49,
OTHER PNEUMONIA,1392,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2168.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2168.96,2168.96,
OTHER PNEUMONIA,1393,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3096.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3096.53,3096.53,
OTHER PNEUMONIA,1394,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4880.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4880.08,4880.08,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,1401,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1839.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1839.82,1839.82,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,1402,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.98,2298.98,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,1403,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2816.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2816.2,2816.2,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,1404,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4381.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4381.03,4381.03,
ASTHMA,1411,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1546.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1546.66,1546.66,
ASTHMA,1412,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.21,2292.21,
ASTHMA,1413,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2656.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2656.61,2656.61,
ASTHMA,1414,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4935.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4935.65,4935.65,
INTERSTITIAL AND ALVEOLAR LUNG DISEASES,1421,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2409.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2409.05,2409.05,
INTERSTITIAL AND ALVEOLAR LUNG DISEASES,1422,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2864.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2864.28,2864.28,
INTERSTITIAL AND ALVEOLAR LUNG DISEASES,1423,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3959.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3959.27,3959.27,
INTERSTITIAL AND ALVEOLAR LUNG DISEASES,1424,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6384.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6384.35,6384.35,
"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1431,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1983.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1983.38,1983.38,
"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1432,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2799.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2799.1,2799.1,
"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1433,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4176.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4176.56,4176.56,
"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1434,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6865.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6865.95,6865.95,
"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1441,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1995.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1995.13,1995.13,
"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1442,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,2624.91,
"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1443,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3699.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3699.24,3699.24,
"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",1444,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6838.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6838.52,6838.52,
ACUTE BRONCHITIS AND RELATED SYMPTOMS,1451,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1835.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1835.19,1835.19,
ACUTE BRONCHITIS AND RELATED SYMPTOMS,1452,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2302.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2302.54,2302.54,
ACUTE BRONCHITIS AND RELATED SYMPTOMS,1453,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2910.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2910.95,2910.95,
ACUTE BRONCHITIS AND RELATED SYMPTOMS,1454,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4679.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4679.89,4679.89,
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,1601,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10572.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10572.67,10572.67,
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,1602,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13714.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13714.8,13714.8,
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,1603,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22480.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22480.77,22480.77,
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,1604,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,49221.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,49221.81,49221.81,
IMPLANTABLE HEART ASSIST SYSTEMS,1611,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,47891.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,47891.37,47891.37,
IMPLANTABLE HEART ASSIST SYSTEMS,1612,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50424.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50424.02,50424.02,
IMPLANTABLE HEART ASSIST SYSTEMS,1613,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,62037.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,62037.18,62037.18,
IMPLANTABLE HEART ASSIST SYSTEMS,1614,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90694.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90694.98,90694.98,
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1621,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14906.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14906.32,14906.32,
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1622,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17816.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17816.56,17816.56,
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1623,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23555.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23555.81,23555.81,
CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1624,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,36754.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,36754.46,36754.46,
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1631,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12902.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12902.28,12902.28,
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1632,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14623.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14623.13,14623.13,
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1633,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19554.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19554.5,19554.5,
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1634,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31047.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31047.62,31047.62,
CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1651,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12992.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12992.76,12992.76,
CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1652,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15096.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15096.54,15096.54,
CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1653,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19299.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19299.81,19299.81,
CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1654,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28506.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28506.06,28506.06,
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1661,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10931.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10931.02,10931.02,
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1662,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12703.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12703.52,12703.52,
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1663,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15860.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15860.96,15860.96,
CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,1664,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25269.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25269.89,25269.89,
OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,1671,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.04,10620.04,
OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,1672,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11241.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11241.63,11241.63,
OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,1673,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17702.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17702.21,17702.21,
OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES,1674,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31902.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31902.52,31902.52,
MAJOR ABDOMINAL VASCULAR PROCEDURES,1691,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9663.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9663.98,9663.98,
MAJOR ABDOMINAL VASCULAR PROCEDURES,1692,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10063.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10063.64,10063.64,
MAJOR ABDOMINAL VASCULAR PROCEDURES,1693,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13835.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13835.91,13835.91,
MAJOR ABDOMINAL VASCULAR PROCEDURES,1694,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23614.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23614.94,23614.94,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",1701,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7142.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7142.72,7142.72,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",1702,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7978.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7978.39,7978.39,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",1703,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11354.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11354.19,11354.19,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",1704,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16802.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16802.07,16802.07,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",1711,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5485.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5485.28,5485.28,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",1712,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6370.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6370.46,6370.46,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",1713,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8414.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8414.04,8414.04,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",1714,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13257.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13257.78,13257.78,
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,1741,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6543.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6543.22,6543.22,
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,1742,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7279.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7279.86,7279.86,
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,1743,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9279.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9279.27,9279.27,
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,1744,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13695.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13695.56,13695.56,
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,1751,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7528.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7528.14,7528.14,
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,1752,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8351.34,8351.34,
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,1753,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10366.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10366.07,10366.07,
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,1754,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15436.72,15436.72,
"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",1761,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5976.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5976.85,5976.85,
"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",1762,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7304.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7304.8,7304.8,
"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",1763,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11593.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11593.92,11593.92,
"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",1764,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18760.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18760.51,18760.51,
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,1771,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4704.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4704.47,4704.47,
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,1772,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6434.22,6434.22,
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,1773,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9280.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9280.34,9280.34,
CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,1774,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12977.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12977.09,12977.09,
EXTERNAL HEART ASSIST SYSTEMS,1781,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16953.81,16953.81,
EXTERNAL HEART ASSIST SYSTEMS,1782,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21124.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21124.32,21124.32,
EXTERNAL HEART ASSIST SYSTEMS,1783,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21719.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21719.19,21719.19,
EXTERNAL HEART ASSIST SYSTEMS,1784,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30267.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30267.52,30267.52,
DEFIBRILLATOR IMPLANTS,1791,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12524.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12524.34,12524.34,
DEFIBRILLATOR IMPLANTS,1792,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14121.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14121.95,14121.95,
DEFIBRILLATOR IMPLANTS,1793,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17415.11,17415.11,
DEFIBRILLATOR IMPLANTS,1794,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23918.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23918.79,23918.79,
OTHER CIRCULATORY SYSTEM PROCEDURES,1801,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4359.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4359.3,4359.3,
OTHER CIRCULATORY SYSTEM PROCEDURES,1802,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,5649.85,
OTHER CIRCULATORY SYSTEM PROCEDURES,1803,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7990.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7990.15,7990.15,
OTHER CIRCULATORY SYSTEM PROCEDURES,1804,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15034.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15034.91,15034.91,
LOWER EXTREMITY ARTERIAL PROCEDURES,1811,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5151.15,5151.15,
LOWER EXTREMITY ARTERIAL PROCEDURES,1812,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7527.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7527.79,7527.79,
LOWER EXTREMITY ARTERIAL PROCEDURES,1813,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12449.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12449.18,12449.18,
LOWER EXTREMITY ARTERIAL PROCEDURES,1814,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20308.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20308.24,20308.24,
OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,1821,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7101.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7101.05,7101.05,
OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,1822,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7983.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7983.02,7983.02,
OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,1823,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9791.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9791.14,9791.14,
OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,1824,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18052.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18052.01,18052.01,
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,1831,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13691.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13691.64,13691.64,
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,1832,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14337.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14337.81,14337.81,
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,1833,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17350.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17350.99,17350.99,
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,1834,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25662.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25662.08,25662.08,
ACUTE MYOCARDIAL INFARCTION,1901,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2783.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2783.42,2783.42,
ACUTE MYOCARDIAL INFARCTION,1902,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3109.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3109.71,3109.71,
ACUTE MYOCARDIAL INFARCTION,1903,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4111.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4111.02,4111.02,
ACUTE MYOCARDIAL INFARCTION,1904,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6506.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6506.18,6506.18,
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,1911,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3336.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3336.26,3336.26,
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,1912,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3876.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3876.28,3876.28,
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,1913,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5251.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5251.25,5251.25,
CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,1914,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8115.53,8115.53,
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,1921,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3622.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3622.3,3622.3,
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,1922,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4466.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4466.87,4466.87,
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,1923,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6472.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6472.34,6472.34,
CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,1924,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10742.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10742.58,10742.58,
ACUTE AND SUBACUTE ENDOCARDITIS,1931,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2984.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2984.33,2984.33,
ACUTE AND SUBACUTE ENDOCARDITIS,1932,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.23,4275.23,
ACUTE AND SUBACUTE ENDOCARDITIS,1933,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5619.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5619.21,5619.21,
ACUTE AND SUBACUTE ENDOCARDITIS,1934,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9360.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9360.84,9360.84,
HEART FAILURE,1941,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1838.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1838.4,1838.4,
HEART FAILURE,1942,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2470.67,2470.67,
HEART FAILURE,1943,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3479.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3479.82,3479.82,
HEART FAILURE,1944,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5697.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5697.94,5697.94,
CARDIAC ARREST AND SHOCK,1961,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1568.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1568.75,1568.75,
CARDIAC ARREST AND SHOCK,1962,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2073.14,2073.14,
CARDIAC ARREST AND SHOCK,1963,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3374.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3374.38,3374.38,
CARDIAC ARREST AND SHOCK,1964,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6680.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6680.01,6680.01,
PERIPHERAL AND OTHER VASCULAR DISORDERS,1971,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2017.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2017.22,2017.22,
PERIPHERAL AND OTHER VASCULAR DISORDERS,1972,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.36,2616.36,
PERIPHERAL AND OTHER VASCULAR DISORDERS,1973,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3621.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3621.59,3621.59,
PERIPHERAL AND OTHER VASCULAR DISORDERS,1974,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,7338.28,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,1981,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1937.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1937.07,1937.07,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,1982,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2231.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2231.3,2231.3,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,1983,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2951.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2951.2,2951.2,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,1984,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5675.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5675.49,5675.49,
HYPERTENSION,1991,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1948.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1948.82,1948.82,
HYPERTENSION,1992,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2298.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2298.62,2298.62,
HYPERTENSION,1993,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3244.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3244.72,3244.72,
HYPERTENSION,1994,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4903.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4903.59,4903.59,
CARDIAC STRUCTURAL AND VALVULAR DISORDERS,2001,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2074.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2074.92,2074.92,
CARDIAC STRUCTURAL AND VALVULAR DISORDERS,2002,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2797.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2797.67,2797.67,
CARDIAC STRUCTURAL AND VALVULAR DISORDERS,2003,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4088.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4088.93,4088.93,
CARDIAC STRUCTURAL AND VALVULAR DISORDERS,2004,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6801.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6801.83,6801.83,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,2011,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.8,1631.8,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,2012,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2108.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2108.05,2108.05,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,2013,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3158.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3158.87,3158.87,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,2014,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5521.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5521.26,5521.26,
CHEST PAIN,2031,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2062.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2062.1,2062.1,
CHEST PAIN,2032,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2305.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2305.75,2305.75,
CHEST PAIN,2033,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2794.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2794.11,2794.11,
CHEST PAIN,2034,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4622.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4622.89,4622.89,
SYNCOPE AND COLLAPSE,2041,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2274.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2274.76,2274.76,
SYNCOPE AND COLLAPSE,2042,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2520.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2520.54,2520.54,
SYNCOPE AND COLLAPSE,2043,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3169.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3169.2,3169.2,
SYNCOPE AND COLLAPSE,2044,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,5290.43,
CARDIOMYOPATHY,2051,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2121.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2121.23,2121.23,
CARDIOMYOPATHY,2052,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2402.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2402.28,2402.28,
CARDIOMYOPATHY,2053,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3855.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3855.97,3855.97,
CARDIOMYOPATHY,2054,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7284.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7284.85,7284.85,
"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",2061,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2808,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2808,2808,
"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",2062,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2891.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2891.36,2891.36,
"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",2063,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4174.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4174.42,4174.42,
"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",2064,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8315.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8315.72,8315.72,
OTHER CIRCULATORY SYSTEM DIAGNOSES,2071,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2007.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2007.24,2007.24,
OTHER CIRCULATORY SYSTEM DIAGNOSES,2072,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2568.99,2568.99,
OTHER CIRCULATORY SYSTEM DIAGNOSES,2073,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3616.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3616.96,3616.96,
OTHER CIRCULATORY SYSTEM DIAGNOSES,2074,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6600.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6600.57,6600.57,
"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2201,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5188.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5188.91,5188.91,
"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2202,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7627.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7627.17,7627.17,
"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2203,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11929.12,11929.12,
"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2204,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22772.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22772.51,22772.51,
"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2221,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,2944.79,
"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2222,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4960.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4960.22,4960.22,
"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2223,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7572.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7572.31,7572.31,
"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",2224,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17163.98,17163.98,
OTHER SMALL AND LARGE BOWEL PROCEDURES,2231,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,3722.39,
OTHER SMALL AND LARGE BOWEL PROCEDURES,2232,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5483.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5483.14,5483.14,
OTHER SMALL AND LARGE BOWEL PROCEDURES,2233,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8073.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8073.14,8073.14,
OTHER SMALL AND LARGE BOWEL PROCEDURES,2234,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16016.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16016.27,16016.27,
PERITONEAL ADHESIOLYSIS,2241,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4275.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4275.59,4275.59,
PERITONEAL ADHESIOLYSIS,2242,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5340.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5340.66,5340.66,
PERITONEAL ADHESIOLYSIS,2243,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8001.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8001.19,8001.19,
PERITONEAL ADHESIOLYSIS,2244,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14451.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14451.8,14451.8,
ANAL AND PERINEAL PROCEDURES,2261,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3153.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3153.53,3153.53,
ANAL AND PERINEAL PROCEDURES,2262,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4262.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4262.05,4262.05,
ANAL AND PERINEAL PROCEDURES,2263,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6644.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6644.39,6644.39,
ANAL AND PERINEAL PROCEDURES,2264,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12216.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12216.22,12216.22,
"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",2271,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4311.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4311.57,4311.57,
"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",2272,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5306.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5306.46,5306.46,
"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",2273,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7939.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7939.21,7939.21,
"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",2274,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15425.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15425.32,15425.32,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",2281,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3403.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3403.94,3403.94,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",2282,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4250.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4250.3,4250.3,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",2283,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5998.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5998.93,5998.93,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",2284,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10245.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10245.31,10245.31,
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,2291,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4138.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4138.8,4138.8,
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,2292,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5818.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5818.69,5818.69,
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,2293,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8872.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8872.83,8872.83,
OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,2294,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16172.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16172.65,16172.65,
MAJOR SMALL BOWEL PROCEDURES,2301,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4689.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4689.5,4689.5,
MAJOR SMALL BOWEL PROCEDURES,2302,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6597.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6597.01,6597.01,
MAJOR SMALL BOWEL PROCEDURES,2303,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10020.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10020.19,10020.19,
MAJOR SMALL BOWEL PROCEDURES,2304,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19705.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19705.54,19705.54,
MAJOR LARGE BOWEL PROCEDURES,2311,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5044.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5044.29,5044.29,
MAJOR LARGE BOWEL PROCEDURES,2312,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6454.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6454.53,6454.53,
MAJOR LARGE BOWEL PROCEDURES,2313,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9547.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9547.85,9547.85,
MAJOR LARGE BOWEL PROCEDURES,2314,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16692.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16692.36,16692.36,
GASTRIC FUNDOPLICATION,2321,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3844.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3844.93,3844.93,
GASTRIC FUNDOPLICATION,2322,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4988.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4988.01,4988.01,
GASTRIC FUNDOPLICATION,2323,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7613.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7613.63,7613.63,
GASTRIC FUNDOPLICATION,2324,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20007.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20007.6,20007.6,
APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,2331,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3614.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3614.46,3614.46,
APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,2332,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.49,4611.49,
APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,2333,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6790.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6790.79,6790.79,
APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,2334,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10094.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10094.99,10094.99,
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,2341,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3319.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3319.16,3319.16,
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,2342,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4026.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4026.24,4026.24,
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,2343,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6094.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6094.4,6094.4,
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,2344,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10620.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10620.4,10620.4,
DIGESTIVE MALIGNANCY,2401,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.97,3009.97,
DIGESTIVE MALIGNANCY,2402,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3320.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3320.59,3320.59,
DIGESTIVE MALIGNANCY,2403,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4698.77,4698.77,
DIGESTIVE MALIGNANCY,2404,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8320.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8320.71,8320.71,
PEPTIC ULCER AND GASTRITIS,2411,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2266.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2266.56,2266.56,
PEPTIC ULCER AND GASTRITIS,2412,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.85,2701.85,
PEPTIC ULCER AND GASTRITIS,2413,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4029.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4029.8,4029.8,
PEPTIC ULCER AND GASTRITIS,2414,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8459.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8459.63,8459.63,
MAJOR ESOPHAGEAL DISORDERS,2421,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2097.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2097.36,2097.36,
MAJOR ESOPHAGEAL DISORDERS,2422,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2642.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2642.72,2642.72,
MAJOR ESOPHAGEAL DISORDERS,2423,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3791.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3791.5,3791.5,
MAJOR ESOPHAGEAL DISORDERS,2424,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8587.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8587.15,8587.15,
OTHER ESOPHAGEAL DISORDERS,2431,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2172.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2172.17,2172.17,
OTHER ESOPHAGEAL DISORDERS,2432,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2616.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2616.72,2616.72,
OTHER ESOPHAGEAL DISORDERS,2433,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3722.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3722.39,3722.39,
OTHER ESOPHAGEAL DISORDERS,2434,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7518.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7518.17,7518.17,
DIVERTICULITIS AND DIVERTICULOSIS,2441,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1831.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1831.63,1831.63,
DIVERTICULITIS AND DIVERTICULOSIS,2442,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2465.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2465.33,2465.33,
DIVERTICULITIS AND DIVERTICULOSIS,2443,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3846.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3846.71,3846.71,
DIVERTICULITIS AND DIVERTICULOSIS,2444,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,7094.63,
INFLAMMATORY BOWEL DISEASE,2451,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2068.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2068.16,2068.16,
INFLAMMATORY BOWEL DISEASE,2452,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2701.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2701.5,2701.5,
INFLAMMATORY BOWEL DISEASE,2453,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4077.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4077.54,4077.54,
INFLAMMATORY BOWEL DISEASE,2454,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7515.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7515.67,7515.67,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,2461,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,2087.75,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,2462,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2672.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2672.29,2672.29,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,2463,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4008.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4008.07,4008.07,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,2464,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6223.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6223.34,6223.34,
INTESTINAL OBSTRUCTION,2471,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1682.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1682.74,1682.74,
INTESTINAL OBSTRUCTION,2472,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2229.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2229.52,2229.52,
INTESTINAL OBSTRUCTION,2473,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.63,3497.63,
INTESTINAL OBSTRUCTION,2474,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7173.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7173.36,7173.36,
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,2481,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1858.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1858.35,1858.35,
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,2482,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2503.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2503.44,2503.44,
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,2483,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3840.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3840.3,3840.3,
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,2484,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7872.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7872.24,7872.24,
"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",2491,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1729.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1729.04,1729.04,
"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",2492,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2089.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2089.17,2089.17,
"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",2493,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.93,3107.93,
"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",2494,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6431.73,6431.73,
ABDOMINAL PAIN,2511,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1942.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1942.77,1942.77,
ABDOMINAL PAIN,2512,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.51,2343.51,
ABDOMINAL PAIN,2513,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3164.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3164.21,3164.21,
ABDOMINAL PAIN,2514,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5758.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5758.85,5758.85,
"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",2521,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2256.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2256.59,2256.59,
"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",2522,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2849.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2849.32,2849.32,
"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",2523,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4223.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4223.94,4223.94,
"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",2524,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8803.02,8803.02,
OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,2531,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2063.88,2063.88,
OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,2532,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2680.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2680.84,2680.84,
OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,2533,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,3898.72,
OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,2534,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7226.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7226.43,7226.43,
OTHER DIGESTIVE SYSTEM DIAGNOSES,2541,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1991.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1991.93,1991.93,
OTHER DIGESTIVE SYSTEM DIAGNOSES,2542,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2581.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2581.81,2581.81,
OTHER DIGESTIVE SYSTEM DIAGNOSES,2543,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3829.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3829.26,3829.26,
OTHER DIGESTIVE SYSTEM DIAGNOSES,2544,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7136.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7136.67,7136.67,
"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",2601,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6743.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6743.41,6743.41,
"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",2602,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8326.41,8326.41,
"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",2603,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11810.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11810.14,11810.14,
"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",2604,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24390.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24390.05,24390.05,
MAJOR BILIARY TRACT PROCEDURES,2611,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5261.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5261.58,5261.58,
MAJOR BILIARY TRACT PROCEDURES,2612,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.28,7338.28,
MAJOR BILIARY TRACT PROCEDURES,2613,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10636.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10636.79,10636.79,
MAJOR BILIARY TRACT PROCEDURES,2614,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20163.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20163.98,20163.98,
CHOLECYSTECTOMY,2631,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3974.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3974.23,3974.23,
CHOLECYSTECTOMY,2632,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4887.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4887.56,4887.56,
CHOLECYSTECTOMY,2633,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6171.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6171.69,6171.69,
CHOLECYSTECTOMY,2634,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12816.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12816.79,12816.79,
"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",2641,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5078.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5078.49,5078.49,
"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",2642,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5649.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5649.85,5649.85,
"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",2643,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8553.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8553.67,8553.67,
"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",2644,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19440.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19440.52,19440.52,
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,2791,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1879.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1879.72,1879.72,
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,2792,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2387.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2387.32,2387.32,
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,2793,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3778.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3778.68,3778.68,
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,2794,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8660.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8660.53,8660.53,
ALCOHOLIC LIVER DISEASE,2801,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1934.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1934.58,1934.58,
ALCOHOLIC LIVER DISEASE,2802,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2523.75,2523.75,
ALCOHOLIC LIVER DISEASE,2803,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3933.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3933.63,3933.63,
ALCOHOLIC LIVER DISEASE,2804,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9129.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9129.31,9129.31,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,2811,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2782,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2782,2782,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,2812,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.58,3351.58,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,2813,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4445.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4445.86,4445.86,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,2814,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7015.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7015.2,7015.2,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY,2821,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1876.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1876.87,1876.87,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY,2822,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2487.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2487.06,2487.06,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY,2823,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.47,3967.47,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY,2824,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9588.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9588.1,9588.1,
OTHER DISORDERS OF THE LIVER,2831,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1955.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1955.59,1955.59,
OTHER DISORDERS OF THE LIVER,2832,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2462.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2462.48,2462.48,
OTHER DISORDERS OF THE LIVER,2833,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3680.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3680.72,3680.72,
OTHER DISORDERS OF THE LIVER,2834,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7715.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7715.15,7715.15,
DISORDERS OF GALLBLADDER AND BILIARY TRACT,2841,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2496.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2496.68,2496.68,
DISORDERS OF GALLBLADDER AND BILIARY TRACT,2842,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3174.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3174.19,3174.19,
DISORDERS OF GALLBLADDER AND BILIARY TRACT,2843,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4442.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4442.29,4442.29,
DISORDERS OF GALLBLADDER AND BILIARY TRACT,2844,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8352.77,8352.77,
DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,3031,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14974.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14974.71,14974.71,
DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,3032,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18864.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18864.17,18864.17,
DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,3033,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27382.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27382.93,27382.93,
DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,3034,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,38583.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,38583.95,38583.95,
DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,3041,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9527.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9527.55,9527.55,
DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,3042,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11958.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11958.33,11958.33,
DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,3043,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17924.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17924.13,17924.13,
DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,3044,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27927.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27927.58,27927.58,
AMPUTATION OF LOWER LIMB EXCEPT TOES,3051,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3556.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3556.76,3556.76,
AMPUTATION OF LOWER LIMB EXCEPT TOES,3052,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4946.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4946.69,4946.69,
AMPUTATION OF LOWER LIMB EXCEPT TOES,3053,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7938.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7938.85,7938.85,
AMPUTATION OF LOWER LIMB EXCEPT TOES,3054,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15672.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15672.53,15672.53,
HIP AND FEMUR FRACTURE REPAIR,3081,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4680.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4680.24,4680.24,
HIP AND FEMUR FRACTURE REPAIR,3082,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5523.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5523.75,5523.75,
HIP AND FEMUR FRACTURE REPAIR,3083,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7378.89,7378.89,
HIP AND FEMUR FRACTURE REPAIR,3084,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11196.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11196.04,11196.04,
OTHER SIGNIFICANT HIP AND FEMUR SURGERY,3091,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5071.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5071.01,5071.01,
OTHER SIGNIFICANT HIP AND FEMUR SURGERY,3092,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6731.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6731.66,6731.66,
OTHER SIGNIFICANT HIP AND FEMUR SURGERY,3093,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9912.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9912.97,9912.97,
OTHER SIGNIFICANT HIP AND FEMUR SURGERY,3094,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15876.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15876.64,15876.64,
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,3101,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4189.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4189.39,4189.39,
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,3102,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5705.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5705.77,5705.77,
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,3103,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8325.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8325.34,8325.34,
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,3104,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15518.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15518.29,15518.29,
"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",3121,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5039.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5039.66,5039.66,
"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",3122,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8085.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8085.61,8085.61,
"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",3123,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13470.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13470.44,13470.44,
"SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES",3124,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29224.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29224.18,29224.18,
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,3131,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4736.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4736.88,4736.88,
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,3132,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6247.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6247.57,6247.57,
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,3133,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9642.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9642.25,9642.25,
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,3134,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15690.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15690.34,15690.34,
FOOT AND TOE PROCEDURES,3141,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4185.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4185.11,4185.11,
FOOT AND TOE PROCEDURES,3142,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4253.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4253.86,4253.86,
FOOT AND TOE PROCEDURES,3143,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5825.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5825.81,5825.81,
FOOT AND TOE PROCEDURES,3144,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10953.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10953.81,10953.81,
"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",3151,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3909.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3909.05,3909.05,
"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",3152,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5847.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5847.54,5847.54,
"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",3153,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8886.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8886.37,8886.37,
"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",3154,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15768.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15768.7,15768.7,
HAND AND WRIST PROCEDURES,3161,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3263.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3263.24,3263.24,
HAND AND WRIST PROCEDURES,3162,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4370.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4370.34,4370.34,
HAND AND WRIST PROCEDURES,3163,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6894.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6894.09,6894.09,
HAND AND WRIST PROCEDURES,3164,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12228.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12228.69,12228.69,
"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",3171,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3572.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3572.43,3572.43,
"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",3172,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4640.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4640.7,4640.7,
"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",3173,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7533.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7533.13,7533.13,
"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",3174,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14367.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14367.73,14367.73,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,3201,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3956.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3956.07,3956.07,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,3202,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5519.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5519.47,5519.47,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,3203,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8126.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8126.22,8126.22,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,3204,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15000,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15000,15000,
SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,3211,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6276.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6276.42,6276.42,
SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,3212,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7870.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7870.82,7870.82,
SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,3213,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11290.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11290.79,11290.79,
SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,3214,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18366.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18366.19,18366.19,
SHOULDER AND ELBOW JOINT REPLACEMENT,3221,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5516.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5516.62,5516.62,
SHOULDER AND ELBOW JOINT REPLACEMENT,3222,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6201.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6201.62,6201.62,
SHOULDER AND ELBOW JOINT REPLACEMENT,3223,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8929.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8929.83,8929.83,
SHOULDER AND ELBOW JOINT REPLACEMENT,3224,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12023.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12023.51,12023.51,
NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,3231,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5399.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5399.07,5399.07,
NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,3232,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6204.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6204.82,6204.82,
NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,3233,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8541.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8541.2,8541.2,
NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,3234,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12708.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12708.5,12708.5,
ELECTIVE HIP JOINT REPLACEMENT,3241,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4595.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4595.47,4595.47,
ELECTIVE HIP JOINT REPLACEMENT,3242,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5199.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5199.95,5199.95,
ELECTIVE HIP JOINT REPLACEMENT,3243,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7698.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7698.77,7698.77,
ELECTIVE HIP JOINT REPLACEMENT,3244,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13185.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13185.47,13185.47,
NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,3251,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7338.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7338.99,7338.99,
NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,3252,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8479.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8479.22,8479.22,
NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,3253,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11326.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11326.41,11326.41,
NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,3254,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17144.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17144.03,17144.03,
ELECTIVE KNEE JOINT REPLACEMENT,3261,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4530.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4530.28,4530.28,
ELECTIVE KNEE JOINT REPLACEMENT,3262,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.16,5011.16,
ELECTIVE KNEE JOINT REPLACEMENT,3263,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7094.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7094.63,7094.63,
ELECTIVE KNEE JOINT REPLACEMENT,3264,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10389.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10389.58,10389.58,
FRACTURE OF FEMUR,3401,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1719.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1719.43,1719.43,
FRACTURE OF FEMUR,3402,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2136.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2136.9,2136.9,
FRACTURE OF FEMUR,3403,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3133.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3133.22,3133.22,
FRACTURE OF FEMUR,3404,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5031.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5031.82,5031.82,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,3411,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1872.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1872.6,1872.6,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,3412,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2250.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2250.89,2250.89,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,3413,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2884.59,2884.59,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,3414,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5464.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5464.26,5464.26,
"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",3421,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2090.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2090.95,2090.95,
"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",3422,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2598.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2598.55,2598.55,
"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",3423,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3582.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3582.05,3582.05,
"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",3424,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6177.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6177.75,6177.75,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,3431,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3182.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3182.74,3182.74,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,3432,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3630.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3630.14,3630.14,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,3433,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5508.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5508.79,5508.79,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,3434,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9347.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9347.66,9347.66,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",3441,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,2647.71,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",3442,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3245.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3245.79,3245.79,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",3443,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4731.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4731.18,4731.18,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",3444,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8056.76,8056.76,
CONNECTIVE TISSUE DISORDERS,3461,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2573.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2573.97,2573.97,
CONNECTIVE TISSUE DISORDERS,3462,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3351.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3351.94,3351.94,
CONNECTIVE TISSUE DISORDERS,3463,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5327.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5327.48,5327.48,
CONNECTIVE TISSUE DISORDERS,3464,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11972.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11972.22,11972.22,
"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",3471,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2436.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2436.83,2436.83,
"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",3472,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2947.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2947.64,2947.64,
"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",3473,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3967.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3967.82,3967.82,
"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",3474,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7270.25,7270.25,
"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",3491,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2176.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2176.8,2176.8,
"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",3492,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2964.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2964.02,2964.02,
"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",3493,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4280.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4280.22,4280.22,
"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",3494,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.79,7989.79,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,3511,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2047.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2047.5,2047.5,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,3512,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2329.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2329.61,2329.61,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,3513,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3563.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3563.17,3563.17,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,3514,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6567.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6567.09,6567.09,
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,3611,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5771.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5771.67,5771.67,
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,3612,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7135.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7135.95,7135.95,
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,3613,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11884.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11884.59,11884.59,
SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,3614,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26226.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26226.67,26226.67,
MASTECTOMY PROCEDURES,3621,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5178.94,5178.94,
MASTECTOMY PROCEDURES,3622,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7377.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7377.11,7377.11,
MASTECTOMY PROCEDURES,3623,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8725.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8725.01,8725.01,
MASTECTOMY PROCEDURES,3624,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12290.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12290.67,12290.67,
BREAST PROCEDURES EXCEPT MASTECTOMY,3631,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4514.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4514.61,4514.61,
BREAST PROCEDURES EXCEPT MASTECTOMY,3632,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7703.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7703.4,7703.4,
BREAST PROCEDURES EXCEPT MASTECTOMY,3633,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9512.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9512.23,9512.23,
BREAST PROCEDURES EXCEPT MASTECTOMY,3634,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15046.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15046.31,15046.31,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",3641,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2892.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2892.43,2892.43,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",3642,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3947.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3947.88,3947.88,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",3643,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6471.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6471.62,6471.62,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",3644,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13267.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13267.4,13267.4,
SKIN ULCERS,3801,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1975.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1975.18,1975.18,
SKIN ULCERS,3802,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2550.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2550.82,2550.82,
SKIN ULCERS,3803,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3879.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3879.13,3879.13,
SKIN ULCERS,3804,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7382.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7382.45,7382.45,
MAJOR SKIN DISORDERS,3811,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1563.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1563.05,1563.05,
MAJOR SKIN DISORDERS,3812,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2717.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2717.17,2717.17,
MAJOR SKIN DISORDERS,3813,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5392.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5392.31,5392.31,
MAJOR SKIN DISORDERS,3814,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11792.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11792.33,11792.33,
MALIGNANT BREAST DISORDERS,3821,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2647.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2647.71,2647.71,
MALIGNANT BREAST DISORDERS,3822,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2972.57,2972.57,
MALIGNANT BREAST DISORDERS,3823,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4147,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4147,4147,
MALIGNANT BREAST DISORDERS,3824,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6364.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6364.4,6364.4,
CELLULITIS AND OTHER SKIN INFECTIONS,3831,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1636.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1636.43,1636.43,
CELLULITIS AND OTHER SKIN INFECTIONS,3832,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2161.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2161.84,2161.84,
CELLULITIS AND OTHER SKIN INFECTIONS,3833,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3294.23,3294.23,
CELLULITIS AND OTHER SKIN INFECTIONS,3834,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6379.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6379.36,6379.36,
"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",3841,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2416.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2416.53,2416.53,
"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",3842,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2771.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2771.31,2771.31,
"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",3843,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3890.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3890.17,3890.17,
"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",3844,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6850.99,6850.99,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",3851,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1807.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1807.41,1807.41,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",3852,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2278.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2278.32,2278.32,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",3853,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3537.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3537.88,3537.88,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",3854,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019.36,8019.36,
ADRENAL PROCEDURES,4011,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.45,4901.45,
ADRENAL PROCEDURES,4012,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8330.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8330.33,8330.33,
ADRENAL PROCEDURES,4013,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11861.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11861.08,11861.08,
ADRENAL PROCEDURES,4014,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22881.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22881.86,22881.86,
PROCEDURES FOR OBESITY,4031,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.62,4016.62,
PROCEDURES FOR OBESITY,4032,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4663.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4663.5,4663.5,
PROCEDURES FOR OBESITY,4033,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7241.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7241.39,7241.39,
PROCEDURES FOR OBESITY,4034,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15947.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15947.52,15947.52,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",4041,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3739.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3739.14,3739.14,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",4042,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5290.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5290.43,5290.43,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",4043,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9126.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9126.81,9126.81,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",4044,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20956.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20956.19,20956.19,
"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",4051,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5248.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5248.75,5248.75,
"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",4052,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5773.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5773.45,5773.45,
"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",4053,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8861.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8861.44,8861.44,
"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",4054,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18421.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18421.4,18421.4,
DIABETES,4201,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1697.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1697.34,1697.34,
DIABETES,4202,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2009.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2009.02,2009.02,
DIABETES,4203,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3073.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3073.38,3073.38,
DIABETES,4204,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6519,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6519,6519,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",4211,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1836.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1836.97,1836.97,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",4212,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2463.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2463.55,2463.55,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",4213,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3770.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3770.84,3770.84,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",4214,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8050.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8050.35,8050.35,
HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,4221,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1369.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1369.63,1369.63,
HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,4222,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,1870.46,
HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,4223,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2809.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2809.43,2809.43,
HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,4224,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5232.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5232.72,5232.72,
INBORN ERRORS OF METABOLISM,4231,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2504.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2504.51,2504.51,
INBORN ERRORS OF METABOLISM,4232,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2991.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2991.1,2991.1,
INBORN ERRORS OF METABOLISM,4233,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5011.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5011.87,5011.87,
INBORN ERRORS OF METABOLISM,4234,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12395.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12395.04,12395.04,
OTHER ENDOCRINE DISORDERS,4241,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2057.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2057.11,2057.11,
OTHER ENDOCRINE DISORDERS,4242,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2828.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2828.66,2828.66,
OTHER ENDOCRINE DISORDERS,4243,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4093.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4093.57,4093.57,
OTHER ENDOCRINE DISORDERS,4244,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7739.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7739.73,7739.73,
OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,4251,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1576.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1576.94,1576.94,
OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,4252,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2048.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2048.56,2048.56,
OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,4253,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2902.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2902.04,2902.04,
OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,4254,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6015.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6015.67,6015.67,
NON-HYPOVOLEMIC SODIUM DISORDERS,4261,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.72,1687.72,
NON-HYPOVOLEMIC SODIUM DISORDERS,4262,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2257.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2257.66,2257.66,
NON-HYPOVOLEMIC SODIUM DISORDERS,4263,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3402.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3402.16,3402.16,
NON-HYPOVOLEMIC SODIUM DISORDERS,4264,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6392.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6392.19,6392.19,
THYROID DISORDERS,4271,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1870.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1870.46,1870.46,
THYROID DISORDERS,4272,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2527.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2527.31,2527.31,
THYROID DISORDERS,4273,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3860.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3860.25,3860.25,
THYROID DISORDERS,4274,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7340.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7340.78,7340.78,
KIDNEY TRANSPLANT,4401,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16323.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16323.32,16323.32,
KIDNEY TRANSPLANT,4402,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17999.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17999.65,17999.65,
KIDNEY TRANSPLANT,4403,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21141.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21141.06,21141.06,
KIDNEY TRANSPLANT,4404,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,34073.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,34073.27,34073.27,
MAJOR BLADDER PROCEDURES,4411,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5050.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5050.7,5050.7,
MAJOR BLADDER PROCEDURES,4412,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7931.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7931.73,7931.73,
MAJOR BLADDER PROCEDURES,4413,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10594.04,10594.04,
MAJOR BLADDER PROCEDURES,4414,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22880.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22880.44,22880.44,
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,4421,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4857.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4857.64,4857.64,
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,4422,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5661.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5661.96,5661.96,
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,4423,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8672.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8672.64,8672.64,
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,4424,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16064.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16064.71,16064.71,
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,4431,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4326.17,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4326.17,4326.17,
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,4432,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5167.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5167.18,5167.18,
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,4433,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7766.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7766.8,7766.8,
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,4434,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14727.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14727.86,14727.86,
RENAL DIALYSIS ACCESS DEVICE PROCEDURES,4441,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3741.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3741.27,3741.27,
RENAL DIALYSIS ACCESS DEVICE PROCEDURES,4442,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5781.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5781.29,5781.29,
RENAL DIALYSIS ACCESS DEVICE PROCEDURES,4443,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8415.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8415.11,8415.11,
RENAL DIALYSIS ACCESS DEVICE PROCEDURES,4444,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15394.68,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15394.68,15394.68,
OTHER BLADDER PROCEDURES,4451,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3595.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3595.94,3595.94,
OTHER BLADDER PROCEDURES,4452,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4529.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4529.57,4529.57,
OTHER BLADDER PROCEDURES,4453,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6623.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6623.72,6623.72,
OTHER BLADDER PROCEDURES,4454,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12064.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12064.12,12064.12,
URETHRAL AND TRANSURETHRAL PROCEDURES,4461,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3107.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3107.22,3107.22,
URETHRAL AND TRANSURETHRAL PROCEDURES,4462,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3715.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3715.98,3715.98,
URETHRAL AND TRANSURETHRAL PROCEDURES,4463,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6056.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6056.28,6056.28,
URETHRAL AND TRANSURETHRAL PROCEDURES,4464,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10505.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10505.35,10505.35,
"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",4471,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4471.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4471.86,4471.86,
"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",4472,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5715.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5715.75,5715.75,
"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",4473,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8269.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8269.06,8269.06,
"OTHER KIDNEY, URINARY TRACT AND RELATED PROCEDURES",4474,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17345.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17345.65,17345.65,
KIDNEY AND URINARY TRACT MALIGNANCY,4611,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2732.84,2732.84,
KIDNEY AND URINARY TRACT MALIGNANCY,4612,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3009.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3009.26,3009.26,
KIDNEY AND URINARY TRACT MALIGNANCY,4613,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.08,4496.08,
KIDNEY AND URINARY TRACT MALIGNANCY,4614,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7165.52,7165.52,
NEPHRITIS AND NEPHROSIS,4621,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1888.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1888.27,1888.27,
NEPHRITIS AND NEPHROSIS,4622,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2624.91,2624.91,
NEPHRITIS AND NEPHROSIS,4623,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5025.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5025.41,5025.41,
NEPHRITIS AND NEPHROSIS,4624,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11093.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11093.8,11093.8,
KIDNEY AND URINARY TRACT INFECTIONS,4631,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1789.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1789.6,1789.6,
KIDNEY AND URINARY TRACT INFECTIONS,4632,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2135.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2135.12,2135.12,
KIDNEY AND URINARY TRACT INFECTIONS,4633,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2924.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2924.84,2924.84,
KIDNEY AND URINARY TRACT INFECTIONS,4634,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4917.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4917.12,4917.12,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,4651,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1926.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1926.03,1926.03,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,4652,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2335.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2335.31,2335.31,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,4653,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3727.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3727.74,3727.74,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,4654,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7028.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7028.74,7028.74,
"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",4661,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1721.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1721.56,1721.56,
"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",4662,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2328.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2328.9,2328.9,
"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",4663,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3490.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3490.5,3490.5,
"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",4664,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5972.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5972.57,5972.57,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",4681,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1861.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1861.91,1861.91,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",4682,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2489.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2489.91,2489.91,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",4683,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.56,3548.56,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",4684,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6302.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6302.78,6302.78,
ACUTE KIDNEY INJURY,4691,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1658.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1658.51,1658.51,
ACUTE KIDNEY INJURY,4692,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2245.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2245.55,2245.55,
ACUTE KIDNEY INJURY,4693,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3624.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3624.79,3624.79,
ACUTE KIDNEY INJURY,4694,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7369.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7369.98,7369.98,
CHRONIC KIDNEY DISEASE,4701,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1664.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1664.21,1664.21,
CHRONIC KIDNEY DISEASE,4702,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2292.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2292.57,2292.57,
CHRONIC KIDNEY DISEASE,4703,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3548.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3548.21,3548.21,
CHRONIC KIDNEY DISEASE,4704,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6782.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6782.95,6782.95,
MAJOR MALE PELVIC PROCEDURES,4801,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4635.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4635.72,4635.72,
MAJOR MALE PELVIC PROCEDURES,4802,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5230.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5230.59,5230.59,
MAJOR MALE PELVIC PROCEDURES,4803,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8386.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8386.96,8386.96,
MAJOR MALE PELVIC PROCEDURES,4804,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13491.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13491.45,13491.45,
TRANSURETHRAL PROSTATECTOMY,4821,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2845.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2845.76,2845.76,
TRANSURETHRAL PROSTATECTOMY,4822,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3399.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3399.31,3399.31,
TRANSURETHRAL PROSTATECTOMY,4823,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.23,6294.23,
TRANSURETHRAL PROSTATECTOMY,4824,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10717.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10717.29,10717.29,
"PENIS, TESTES AND SCROTAL PROCEDURES",4831,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3952.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3952.86,3952.86,
"PENIS, TESTES AND SCROTAL PROCEDURES",4832,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5004.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5004.75,5004.75,
"PENIS, TESTES AND SCROTAL PROCEDURES",4833,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7308.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7308.36,7308.36,
"PENIS, TESTES AND SCROTAL PROCEDURES",4834,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14769.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14769.89,14769.89,
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,4841,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4248.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4248.87,4248.87,
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,4842,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5120.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5120.52,5120.52,
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,4843,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6294.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6294.59,6294.59,
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,4844,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14351.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14351.34,14351.34,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",5001,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2500.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2500.24,2500.24,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",5002,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2852.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2852.53,2852.53,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",5003,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4418.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4418.43,4418.43,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",5004,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9385.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9385.42,9385.42,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,5011,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1805.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1805.98,1805.98,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,5012,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2341.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2341.37,2341.37,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,5013,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3544.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3544.65,3544.65,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,5014,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7959.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7959.87,7959.87,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",5101,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4822.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4822.37,4822.37,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",5102,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5829.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5829.02,5829.02,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",5103,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9756.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9756.59,9756.59,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES",5104,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18199.48,18199.48,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,5111,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4863.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4863.69,4863.69,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,5112,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6006.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6006.77,6006.77,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,5113,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9122.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9122.89,9122.89,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,5114,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18204.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18204.11,18204.11,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,5121,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4655.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4655.31,4655.31,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,5122,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5448.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5448.23,5448.23,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,5123,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8831.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8831.87,8831.87,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY,5124,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15569.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15569.23,15569.23,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,5131,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3480.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3480.88,3480.88,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,5132,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4158.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4158.04,4158.04,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,5133,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6854.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6854.55,6854.55,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,5134,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11519.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11519.83,11519.83,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,5141,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.01,2943.01,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,5142,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4481.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4481.48,4481.48,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,5143,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,8711.47,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,5144,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16148.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16148.07,16148.07,
DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,5171,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2603.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2603.54,2603.54,
DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,5172,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3371.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3371.88,3371.88,
DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,5173,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5531.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5531.94,5531.94,
DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,5174,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11493.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11493.83,11493.83,
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,5181,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3232.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3232.61,3232.61,
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,5182,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4688.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4688.08,4688.08,
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,5183,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8286.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8286.87,8286.87,
OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,5184,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16876.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16876.52,16876.52,
UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,5191,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3349.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3349.09,3349.09,
UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,5192,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4274.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4274.88,4274.88,
UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,5193,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7153.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7153.77,7153.77,
UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,5194,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14412.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14412.61,14412.61,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,5301,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2343.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2343.15,2343.15,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,5302,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3000.71,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3000.71,3000.71,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,5303,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,4436.6,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,5304,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8019,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8019,8019,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,5311,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1822.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1822.01,1822.01,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,5312,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2404.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2404.42,2404.42,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,5313,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3954.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3954.29,3954.29,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,5314,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5833.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5833.65,5833.65,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,5321,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1761.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1761.81,1761.81,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,5322,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2059.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2059.25,2059.25,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,5323,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3332.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3332.34,3332.34,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,5324,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6726.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6726.67,6726.67,
CESAREAN SECTION WITH STERILIZATION,5391,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2035.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2035.38,2035.38,
CESAREAN SECTION WITH STERILIZATION,5392,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.81,2446.81,
CESAREAN SECTION WITH STERILIZATION,5393,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3839.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3839.94,3839.94,
CESAREAN SECTION WITH STERILIZATION,5394,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9460.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9460.94,9460.94,
CESAREAN SECTION WITHOUT STERILIZATION,5401,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2029.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2029.33,2029.33,
CESAREAN SECTION WITHOUT STERILIZATION,5402,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.01,2507.01,
CESAREAN SECTION WITHOUT STERILIZATION,5403,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3396.11,3396.11,
CESAREAN SECTION WITHOUT STERILIZATION,5404,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6583.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6583.12,6583.12,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,5411,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2013.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2013.3,2013.3,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,5412,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2075.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2075.99,2075.99,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,5413,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2805.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2805.51,2805.51,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,5414,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4712.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4712.66,4712.66,
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,5421,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1371.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1371.76,1371.76,
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,5422,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1626.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1626.45,1626.45,
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,5423,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2688.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2688.32,2688.32,
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,5424,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7186.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7186.54,7186.54,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5431,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1878.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1878.3,1878.3,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5432,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2364.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2364.52,2364.52,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5433,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3416.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3416.05,3416.05,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5434,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10398.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10398.48,10398.48,
ANTEPARTUM WITH O.R. PROCEDURE,5471,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2571.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2571.84,2571.84,
ANTEPARTUM WITH O.R. PROCEDURE,5472,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3431.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3431.73,3431.73,
ANTEPARTUM WITH O.R. PROCEDURE,5473,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5564,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5564,5564,
ANTEPARTUM WITH O.R. PROCEDURE,5474,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9910.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9910.83,9910.83,
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,5481,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1724.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1724.41,1724.41,
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,5482,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3400.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3400.38,3400.38,
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,5483,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5628.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5628.83,5628.83,
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,5484,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13649.97,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13649.97,13649.97,
VAGINAL DELIVERY,5601,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1195.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1195.8,1195.8,
VAGINAL DELIVERY,5602,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1354.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1354.31,1354.31,
VAGINAL DELIVERY,5603,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1921.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1921.4,1921.4,
VAGINAL DELIVERY,5604,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3117.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3117.55,3117.55,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,5611,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,968.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,968.18,968.18,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,5612,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1506.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1506.77,1506.77,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,5613,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2395.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2395.16,2395.16,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,5614,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5437.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5437.9,5437.9,
"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5641,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1191.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1191.52,1191.52,
"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5642,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1594.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1594.75,1594.75,
"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5643,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2339.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2339.59,2339.59,
"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",5644,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7243.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7243.89,7243.89,
ANTEPARTUM WITHOUT O.R. PROCEDURE,5661,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1024.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1024.46,1024.46,
ANTEPARTUM WITHOUT O.R. PROCEDURE,5662,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1378.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1378.89,1378.89,
ANTEPARTUM WITHOUT O.R. PROCEDURE,5663,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2104.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2104.49,2104.49,
ANTEPARTUM WITHOUT O.R. PROCEDURE,5664,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4413.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4413.44,4413.44,
"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",5801,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1085.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1085.37,1085.37,
"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",5802,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1436.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1436.24,1436.24,
"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",5803,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2518.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2518.4,2518.4,
"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",5804,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4144.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4144.86,4144.86,
"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",5811,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,376.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,376.51,376.51,
"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",5812,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,594.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,594.87,594.87,
"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",5813,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1009.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1009.5,1009.5,
"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",5814,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1868.32,1868.32,
NEONATE WITH ECMO,5831,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,58883.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,58883.65,58883.65,
NEONATE WITH ECMO,5832,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,94073.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,94073.28,94073.28,
NEONATE WITH ECMO,5833,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,136721.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,136721.95,136721.95,
NEONATE WITH ECMO,5834,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,155656.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,155656.65,155656.65,
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,5881,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,77631.34,
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,5882,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,77631.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,77631.34,77631.34,
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,5883,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,81016.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,81016.05,81016.05,
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,5884,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,118544.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,118544.91,118544.91,
"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",5891,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46622.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46622.9,46622.9,
"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",5892,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,44973.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,44973.29,44973.29,
"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",5893,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,42816.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,42816.09,42816.09,
"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",5894,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8112.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8112.33,8112.33,
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,5911,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28425.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28425.91,28425.91,
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,5912,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39426.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39426.39,39426.39,
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,5913,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,53776.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,53776.31,53776.31,
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,5914,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,74593.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,74593.94,74593.94,
NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,5931,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10773.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10773.57,10773.57,
NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,5932,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,41260.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,41260.87,41260.87,
NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,5933,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,46700.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,46700.91,46700.91,
NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,5934,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,68736.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,68736.78,68736.78,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6021,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9656.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9656.5,9656.5,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6022,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30276.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30276.78,30276.78,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6023,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,37732.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,37732.61,37732.61,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6024,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,50763.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,50763.13,50763.13,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6031,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9203.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9203.75,9203.75,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6032,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17461.77,17461.77,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6033,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,31715.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,31715.51,31715.51,
NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6034,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,63501.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,63501.91,63501.91,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6071,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11881.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11881.03,11881.03,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6072,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21653.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21653.29,21653.29,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6073,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27846.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27846.36,27846.36,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,6074,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39740.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39740.57,39740.57,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6081,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5385.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5385.18,5385.18,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6082,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16056.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16056.52,16056.52,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6083,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,21028.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,21028.14,21028.14,
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,6084,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26924.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26924.49,26924.49,
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,6091,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,17841.13,
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,6092,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17841.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17841.13,17841.13,
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,6093,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,33677.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,33677.16,33677.16,
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,6094,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,72863.82,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,72863.82,72863.82,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,6111,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5929.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5929.12,5929.12,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,6112,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11898.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11898.13,11898.13,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,6113,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20334.96,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20334.96,20334.96,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,6114,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35178.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35178.94,35178.94,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6121,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9566.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9566.38,9566.38,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6122,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14595.7,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14595.7,14595.7,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6123,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18636.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18636.55,18636.55,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6124,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28473.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28473.29,28473.29,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6131,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6687.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6687.84,6687.84,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6132,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11320,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11320,11320,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6133,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19127.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19127.41,19127.41,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6134,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,35589.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,35589.3,35589.3,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,6141,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4743.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4743.65,4743.65,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,6142,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9284.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9284.26,9284.26,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,6143,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16469.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16469.01,16469.01,
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,6144,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23568.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23568.99,23568.99,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,6211,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2498.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2498.81,2498.81,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,6212,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7007.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7007.72,7007.72,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,6213,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14794.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14794.83,14794.83,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,6214,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27841.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27841.73,27841.73,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6221,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5954.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5954.41,5954.41,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6222,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8920.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8920.92,8920.92,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6223,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10582.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10582.29,10582.29,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6224,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19270.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19270.25,19270.25,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6231,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4482.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4482.9,4482.9,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6232,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7392.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7392.07,7392.07,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6233,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16273.81,16273.81,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6234,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19844.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19844.46,19844.46,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6251,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5038.23,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5038.23,5038.23,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6252,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.1,6697.1,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6253,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11218.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11218.48,11218.48,
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6254,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,28455.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,28455.84,28455.84,
"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6261,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,687.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,687.13,687.13,
"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6262,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,941.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,941.11,941.11,
"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6263,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2529.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2529.8,2529.8,
"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6264,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8994.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8994.66,8994.66,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,6301,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12567.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12567.45,12567.45,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,6302,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29656.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29656.62,29656.62,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,6303,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,39760.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,39760.87,39760.87,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,6304,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,96391.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,96391.85,96391.85,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,6311,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3898.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3898.72,3898.72,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,6312,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16218.24,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16218.24,16218.24,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,6313,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25647.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25647.12,25647.12,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,6314,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,73605.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,73605.1,73605.1,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,6331,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,950.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,950.01,950.01,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,6332,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3222.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3222.28,3222.28,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,6333,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10232.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10232.84,10232.84,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,6334,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26096.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26096.3,26096.3,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6341,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2507.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2507.72,2507.72,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6342,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5089.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5089.53,5089.53,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6343,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6298.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6298.86,6298.86,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,6344,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17624.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17624.91,17624.91,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6361,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2577.54,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2577.54,2577.54,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6362,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4578.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4578.37,4578.37,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6363,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9200.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9200.9,9200.9,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,6364,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13273.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13273.81,13273.81,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6391,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1867.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1867.25,1867.25,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6392,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2748.87,2748.87,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6393,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7430.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7430.9,7430.9,
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,6394,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10565.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10565.19,10565.19,
"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6401,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,391.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,391.83,391.83,
"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6402,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,576.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,576.35,576.35,
"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6403,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1310.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1310.14,1310.14,
"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",6404,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8084.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8084.9,8084.9,
SPLENECTOMY,6501,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4823.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4823.44,4823.44,
SPLENECTOMY,6502,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6645.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6645.1,6645.1,
SPLENECTOMY,6503,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9983.5,9983.5,
SPLENECTOMY,6504,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,17391.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,17391.95,17391.95,
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,6511,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4137.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4137.38,4137.38,
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,6512,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5955.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5955.83,5955.83,
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,6513,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8291.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8291.5,8291.5,
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,6514,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,25289.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,25289.84,25289.84,
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,6601,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2614.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2614.58,2614.58,
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,6602,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2882.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2882.45,2882.45,
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,6603,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4673.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4673.12,4673.12,
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,6604,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12396.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12396.11,12396.11,
COAGULATION AND PLATELET DISORDERS,6611,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2966.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2966.52,2966.52,
COAGULATION AND PLATELET DISORDERS,6612,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3983.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3983.5,3983.5,
COAGULATION AND PLATELET DISORDERS,6613,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5056.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5056.76,5056.76,
COAGULATION AND PLATELET DISORDERS,6614,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9927.57,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9927.57,9927.57,
SICKLE CELL ANEMIA CRISIS,6621,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2000.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2000.48,2000.48,
SICKLE CELL ANEMIA CRISIS,6622,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2721.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2721.8,2721.8,
SICKLE CELL ANEMIA CRISIS,6623,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4066.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4066.85,4066.85,
SICKLE CELL ANEMIA CRISIS,6624,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7713.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7713.02,7713.02,
OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,6631,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1885.78,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1885.78,1885.78,
OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,6632,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2505.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2505.58,2505.58,
OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,6633,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3596.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3596.65,3596.65,
OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,6634,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6426.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6426.74,6426.74,
"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6801,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5785.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5785.92,5785.92,
"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6802,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7989.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7989.08,7989.08,
"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6803,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13854.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13854.43,13854.43,
"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6804,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29988.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29988.25,29988.25,
"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6811,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4373.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4373.19,4373.19,
"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6812,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6058.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6058.06,6058.06,
"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6813,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10868.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10868.32,10868.32,
"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",6814,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26892.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26892.79,26892.79,
ACUTE LEUKEMIA,6901,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4756.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4756.83,4756.83,
ACUTE LEUKEMIA,6902,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8753.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8753.86,8753.86,
ACUTE LEUKEMIA,6903,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16229.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16229.64,16229.64,
ACUTE LEUKEMIA,6904,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27449.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27449.19,27449.19,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",6911,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3893.73,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3893.73,3893.73,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",6912,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5012.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5012.59,5012.59,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",6913,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7540.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7540.61,7540.61,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",6914,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15266.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15266.09,15266.09,
RADIOTHERAPY,6921,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3235.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3235.1,3235.1,
RADIOTHERAPY,6922,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5470.67,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5470.67,5470.67,
RADIOTHERAPY,6923,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8830.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8830.45,8830.45,
RADIOTHERAPY,6924,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13600.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13600.45,13600.45,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,6941,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2617.07,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2617.07,2617.07,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,6942,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3162.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3162.43,3162.43,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,6943,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4734.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4734.03,4734.03,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,6944,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8930.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8930.18,8930.18,
CHEMOTHERAPY FOR ACUTE LEUKEMIA,6951,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2150.08,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2150.08,2150.08,
CHEMOTHERAPY FOR ACUTE LEUKEMIA,6952,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3357.64,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3357.64,3357.64,
CHEMOTHERAPY FOR ACUTE LEUKEMIA,6953,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8945.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8945.15,8945.15,
CHEMOTHERAPY FOR ACUTE LEUKEMIA,6954,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,24900.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,24900.86,24900.86,
OTHER CHEMOTHERAPY,6961,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2870.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2870.34,2870.34,
OTHER CHEMOTHERAPY,6962,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3471.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3471.98,3471.98,
OTHER CHEMOTHERAPY,6963,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5748.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5748.87,5748.87,
OTHER CHEMOTHERAPY,6964,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12828.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12828.19,12828.19,
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,7101,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4076.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4076.11,4076.11,
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,7102,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5663.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5663.38,5663.38,
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,7103,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9308.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9308.12,9308.12,
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,7104,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18398.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18398.25,18398.25,
"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",7111,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3884.83,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3884.83,3884.83,
"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",7112,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5323.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5323.56,5323.56,
"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",7113,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9061.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9061.27,9061.27,
"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",7114,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18436.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18436.72,18436.72,
SEPTICEMIA AND DISSEMINATED INFECTIONS,7201,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2147.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2147.59,2147.59,
SEPTICEMIA AND DISSEMINATED INFECTIONS,7202,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2726.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2726.79,2726.79,
SEPTICEMIA AND DISSEMINATED INFECTIONS,7203,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4120.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4120.99,4120.99,
SEPTICEMIA AND DISSEMINATED INFECTIONS,7204,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8035.03,8035.03,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",7211,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2151.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2151.15,2151.15,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",7212,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2889.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2889.58,2889.58,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",7213,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4611.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4611.14,4611.14,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",7214,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8711.47,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8711.47,8711.47,
FEVER AND INFLAMMATORY CONDITIONS,7221,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1490.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1490.38,1490.38,
FEVER AND INFLAMMATORY CONDITIONS,7222,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2212.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2212.42,2212.42,
FEVER AND INFLAMMATORY CONDITIONS,7223,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3061.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3061.98,3061.98,
FEVER AND INFLAMMATORY CONDITIONS,7224,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4901.81,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4901.81,4901.81,
VIRAL ILLNESS,7231,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1464.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1464.02,1464.02,
VIRAL ILLNESS,7232,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2052.13,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2052.13,2052.13,
VIRAL ILLNESS,7233,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3216.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3216.58,3216.58,
VIRAL ILLNESS,7234,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7511.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7511.4,7511.4,
OTHER INFECTIOUS AND PARASITIC DISEASES,7241,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2217.41,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2217.41,2217.41,
OTHER INFECTIOUS AND PARASITIC DISEASES,7242,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2650.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2650.2,2650.2,
OTHER INFECTIOUS AND PARASITIC DISEASES,7243,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4436.6,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4436.6,4436.6,
OTHER INFECTIOUS AND PARASITIC DISEASES,7244,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9453.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9453.1,9453.1,
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,7401,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,5052.48,
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,7402,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5052.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5052.48,5052.48,
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,7403,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9911.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9911.9,9911.9,
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,7404,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29171.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29171.11,29171.11,
SCHIZOPHRENIA,7501,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2281.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2281.53,2281.53,
SCHIZOPHRENIA,7502,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2838.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2838.99,2838.99,
SCHIZOPHRENIA,7503,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4895.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4895.39,4895.39,
SCHIZOPHRENIA,7504,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11174.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11174.31,11174.31,
MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES,7511,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.2,1316.2,
MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES,7512,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1873.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1873.66,1873.66,
MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES,7513,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3708.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3708.86,3708.86,
MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES,7514,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7127.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7127.05,7127.05,
DISORDERS OF PERSONALITY AND IMPULSE CONTROL,7521,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1225.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1225.36,1225.36,
DISORDERS OF PERSONALITY AND IMPULSE CONTROL,7522,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1631.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1631.09,1631.09,
DISORDERS OF PERSONALITY AND IMPULSE CONTROL,7523,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4316.55,4316.55,
DISORDERS OF PERSONALITY AND IMPULSE CONTROL,7524,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8648.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8648.42,8648.42,
BIPOLAR DISORDERS,7531,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1484.33,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1484.33,1484.33,
BIPOLAR DISORDERS,7532,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2087.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2087.75,2087.75,
BIPOLAR DISORDERS,7533,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4106.75,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4106.75,4106.75,
BIPOLAR DISORDERS,7534,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7374.62,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7374.62,7374.62,
DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER,7541,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1165.52,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1165.52,1165.52,
DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER,7542,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1642.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1642.84,1642.84,
DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER,7543,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2867.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2867.49,2867.49,
DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER,7544,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6491.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6491.21,6491.21,
ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,7551,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1096.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1096.06,1096.06,
ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,7552,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1628.95,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1628.95,1628.95,
ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,7553,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2699,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2699,2699,
ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,7554,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4177.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4177.27,4177.27,
ACUTE ANXIETY AND DELIRIUM STATES,7561,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1859.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1859.77,1859.77,
ACUTE ANXIETY AND DELIRIUM STATES,7562,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2326.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2326.76,2326.76,
ACUTE ANXIETY AND DELIRIUM STATES,7563,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2484.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2484.21,2484.21,
ACUTE ANXIETY AND DELIRIUM STATES,7564,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5352.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5352.77,5352.77,
ORGANIC MENTAL HEALTH DISTURBANCES,7571,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1855.5,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1855.5,1855.5,
ORGANIC MENTAL HEALTH DISTURBANCES,7572,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2695.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2695.44,2695.44,
ORGANIC MENTAL HEALTH DISTURBANCES,7573,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4016.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4016.98,4016.98,
ORGANIC MENTAL HEALTH DISTURBANCES,7574,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11078.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11078.84,11078.84,
BEHAVIORAL DISORDERS,7581,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1496.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1496.79,1496.79,
BEHAVIORAL DISORDERS,7582,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1810.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1810.26,1810.26,
BEHAVIORAL DISORDERS,7583,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3472.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3472.69,3472.69,
BEHAVIORAL DISORDERS,7584,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18378.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18378.3,18378.3,
EATING DISORDERS,7591,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2252.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2252.32,2252.32,
EATING DISORDERS,7592,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4437.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4437.66,4437.66,
EATING DISORDERS,7593,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6161.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6161.72,6161.72,
EATING DISORDERS,7594,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26573.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26573.27,26573.27,
OTHER MENTAL HEALTH DISORDERS,7601,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.15,2234.15,
OTHER MENTAL HEALTH DISORDERS,7602,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2686.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2686.18,2686.18,
OTHER MENTAL HEALTH DISORDERS,7603,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3850.99,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3850.99,3850.99,
OTHER MENTAL HEALTH DISORDERS,7604,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6697.46,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6697.46,6697.46,
"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",7701,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,985.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,985.63,985.63,
"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",7702,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1503.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1503.56,1503.56,
"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",7703,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2446.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2446.09,2446.09,
"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",7704,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5451.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5451.44,5451.44,
ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,7721,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1745.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1745.43,1745.43,
ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,7722,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2461.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2461.77,2461.77,
ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,7723,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3105.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3105.79,3105.79,
ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,7724,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8586.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8586.8,8586.8,
OPIOID ABUSE AND DEPENDENCE,7731,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1013.77,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1013.77,1013.77,
OPIOID ABUSE AND DEPENDENCE,7732,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1522.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1522.09,1522.09,
OPIOID ABUSE AND DEPENDENCE,7733,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2848.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2848.26,2848.26,
OPIOID ABUSE AND DEPENDENCE,7734,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6786.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6786.87,6786.87,
COCAINE ABUSE AND DEPENDENCE,7741,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1316.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1316.55,1316.55,
COCAINE ABUSE AND DEPENDENCE,7742,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1516.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1516.74,1516.74,
COCAINE ABUSE AND DEPENDENCE,7743,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2739.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2739.25,2739.25,
COCAINE ABUSE AND DEPENDENCE,7744,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,6703.87,
ALCOHOL ABUSE AND DEPENDENCE,7751,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1423.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1423.06,1423.06,
ALCOHOL ABUSE AND DEPENDENCE,7752,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1943.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1943.48,1943.48,
ALCOHOL ABUSE AND DEPENDENCE,7753,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3386.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3386.84,3386.84,
ALCOHOL ABUSE AND DEPENDENCE,7754,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8063.88,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8063.88,8063.88,
OTHER DRUG ABUSE AND DEPENDENCE,7761,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1764.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1764.66,1764.66,
OTHER DRUG ABUSE AND DEPENDENCE,7762,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1780.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1780.34,1780.34,
OTHER DRUG ABUSE AND DEPENDENCE,7763,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3092.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3092.26,3092.26,
OTHER DRUG ABUSE AND DEPENDENCE,7764,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5478.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5478.15,5478.15,
EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7921,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4945.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4945.98,4945.98,
EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7922,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6634.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6634.06,6634.06,
EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7923,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10150.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10150.92,10150.92,
EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7924,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,20453.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,20453.22,20453.22,
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7931,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3810.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3810.38,3810.38,
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7932,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5216.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5216.34,5216.34,
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7933,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7892.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7892.19,7892.19,
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7934,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16594.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16594.04,16594.04,
NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7941,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3205.89,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3205.89,3205.89,
NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7942,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4070.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4070.06,4070.06,
NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7943,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6252.2,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6252.2,6252.2,
NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,7944,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11395.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11395.51,11395.51,
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,8101,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1784.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1784.26,1784.26,
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,8102,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2460.34,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2460.34,2460.34,
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,8103,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3938.26,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3938.26,3938.26,
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,8104,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8253.39,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8253.39,8253.39,
ALLERGIC REACTIONS,8111,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1299.45,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1299.45,1299.45,
ALLERGIC REACTIONS,8112,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1902.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1902.16,1902.16,
ALLERGIC REACTIONS,8113,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3539.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3539.3,3539.3,
ALLERGIC REACTIONS,8114,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7280.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7280.93,7280.93,
POISONING OF MEDICINAL AGENTS,8121,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1422.35,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1422.35,1422.35,
POISONING OF MEDICINAL AGENTS,8122,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1969.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1969.49,1969.49,
POISONING OF MEDICINAL AGENTS,8123,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2868.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2868.56,2868.56,
POISONING OF MEDICINAL AGENTS,8124,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5474.59,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5474.59,5474.59,
OTHER COMPLICATIONS OF TREATMENT,8131,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2235.93,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2235.93,2235.93,
OTHER COMPLICATIONS OF TREATMENT,8132,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2776.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2776.3,2776.3,
OTHER COMPLICATIONS OF TREATMENT,8133,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4006.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4006.65,4006.65,
OTHER COMPLICATIONS OF TREATMENT,8134,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7770.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7770.72,7770.72,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",8151,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1676.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1676.32,1676.32,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",8152,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2234.86,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2234.86,2234.86,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",8153,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3738.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3738.42,3738.42,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",8154,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8633.11,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8633.11,8633.11,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,8161,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,2445.03,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,8162,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2445.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2445.03,2445.03,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,8163,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2895.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2895.27,2895.27,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,8164,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5668.37,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5668.37,5668.37,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,8171,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1393.49,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1393.49,1393.49,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,8172,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1815.25,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1815.25,1815.25,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,8173,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.79,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.79,2944.79,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,8174,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5732.84,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5732.84,5732.84,
EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,8411,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,19597.61,
EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,8412,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,19597.61,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,19597.61,19597.61,
EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,8413,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30158.16,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30158.16,30158.16,
EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,8414,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,90255.42,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,90255.42,90255.42,
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,8421,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5803.02,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5803.02,5803.02,
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,8422,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8600.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8600.69,8600.69,
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,8423,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16790.31,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16790.31,16790.31,
BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,8424,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,40741.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,40741.87,40741.87,
EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,8431,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2115.53,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2115.53,2115.53,
EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,8432,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3497.98,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3497.98,3497.98,
EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,8433,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4496.8,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4496.8,4496.8,
EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,8434,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10207.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10207.55,10207.55,
PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,8441,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1817.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1817.38,1817.38,
PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,8442,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2840.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2840.06,2840.06,
PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,8443,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4497.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4497.51,4497.51,
PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,8444,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12199.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12199.48,12199.48,
"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",8501,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6718.12,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6718.12,6718.12,
"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",8502,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9436,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9436,9436,
"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",8503,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,12625.51,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,12625.51,12625.51,
"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",8504,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,29049.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,29049.28,29049.28,
REHABILITATION,8601,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4007.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4007.36,4007.36,
REHABILITATION,8602,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5292.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5292.92,5292.92,
REHABILITATION,8603,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6618.38,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6618.38,6618.38,
REHABILITATION,8604,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8615.3,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8615.3,8615.3,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",8611,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,1687.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,1687.01,1687.01,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",8612,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2297.55,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2297.55,2297.55,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",8613,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3391.48,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3391.48,3391.48,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",8614,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5035.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5035.03,5035.03,
OTHER AFTERCARE AND CONVALESCENCE,8621,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2191.76,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2191.76,2191.76,
OTHER AFTERCARE AND CONVALESCENCE,8622,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3435.65,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3435.65,3435.65,
OTHER AFTERCARE AND CONVALESCENCE,8623,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3922.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3922.94,3922.94,
OTHER AFTERCARE AND CONVALESCENCE,8624,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4010.21,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4010.21,4010.21,
NEONATAL AFTERCARE,8631,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4414.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4414.87,4414.87,
NEONATAL AFTERCARE,8632,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,9062.69,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,9062.69,9062.69,
NEONATAL AFTERCARE,8633,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,18003.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,18003.92,18003.92,
NEONATAL AFTERCARE,8634,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,30458.09,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,30458.09,30458.09,
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,8901,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3473.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3473.05,3473.05,
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,8902,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3754.1,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3754.1,3754.1,
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,8903,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5605.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5605.32,5605.32,
HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,8904,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11492.05,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11492.05,11492.05,
HIV WITH MAJOR HIV RELATED CONDITION,8921,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2689.03,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2689.03,2689.03,
HIV WITH MAJOR HIV RELATED CONDITION,8922,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3035.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3035.27,3035.27,
HIV WITH MAJOR HIV RELATED CONDITION,8923,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4259.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4259.92,4259.92,
HIV WITH MAJOR HIV RELATED CONDITION,8924,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6703.87,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6703.87,6703.87,
HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,8931,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2943.72,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2943.72,2943.72,
HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,8932,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3434.22,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3434.22,3434.22,
HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,8933,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4748.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4748.28,4748.28,
HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS,8934,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7361.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7361.44,7361.44,
HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,8941,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2359.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2359.18,2359.18,
HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,8942,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2894.56,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2894.56,2894.56,
HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,8943,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4181.19,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4181.19,4181.19,
HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,8944,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,6981.36,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,6981.36,6981.36,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,9101,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,10821.66,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,9102,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,10821.66,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,10821.66,10821.66,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,9103,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,15868.44,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,15868.44,15868.44,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,9104,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,26919.15,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,26919.15,26919.15,
EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9111,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7428.4,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7428.4,7428.4,
EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9112,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8189.27,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8189.27,8189.27,
EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9113,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11673,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11673,11673,
EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9114,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,27085.14,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,27085.14,27085.14,
MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9121,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7637.85,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7637.85,7637.85,
MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9122,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7926.74,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7926.74,7926.74,
MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9123,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,13051.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,13051.18,13051.18,
MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,9124,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,23972.58,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,23972.58,23972.58,
MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,9301,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,2944.43,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,2944.43,2944.43,
MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,9302,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3610.9,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3610.9,3610.9,
MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,9303,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5740.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5740.32,5740.32,
MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,9304,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11897.06,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11897.06,11897.06,
EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9501,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5466.04,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5466.04,5466.04,
EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9502,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7395.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7395.63,7395.63,
EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9503,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,11516.63,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,11516.63,11516.63,
EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9504,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,22498.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,22498.94,22498.94,
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9511,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4166.94,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4166.94,4166.94,
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9512,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,5733.91,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,5733.91,5733.91,
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9513,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,8714.32,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,8714.32,8714.32,
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9514,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,16613.28,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,16613.28,16613.28,
NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9521,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,3423.18,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,3423.18,3423.18,
NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9522,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,4721.92,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,4721.92,4721.92,
NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9523,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,7635.01,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,7635.01,7635.01,
NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,9524,APR-DRG,100,RC,,,inpatient,,,,,,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,14153.29,,APR-DRG,,other,100% of FL Medicaid APR DRG rates for inpatient setting,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,,,,,other,Not reimbursable at APR-DRG per contract terms,14153.29,14153.29,
SUPERFICIAL NEEDLE BIOPSY AND ASPIRATION,2,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,695.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,695.49,695.49,
"LEVEL I SKIN INCISION AND DRAINAGE, DEBRIDEMENT, DESTRUCTION, OTHER RELATED PX",3,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.17,168.17,
"LEVEL II SKIN INCISION AND DRAINAGE, DEBRIDEMENT, DESTRUCTION, OTHER RELATED PX",4,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1092.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1092.51,1092.51,
NAIL PROCEDURES,5,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,67.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,67.69,67.69,
"LEVEL I SKIN EXCISIONS, BIOPSIES, AND REPAIRS",9,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,428.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,428.24,428.24,
"LEVEL II SKIN EXCISIONS, BIOPSIES, AND REPAIRS",10,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1231.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1231.69,1231.69,
"LEVEL III SKIN EXCISIONS, BIOPSIES, AND REPAIRS",11,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1820.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1820.67,1820.67,
SIMPLE WOUND REPAIR AND TREATMENT,16,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.62,185.62,
INTERMEDIATE WOUND REPAIR AND TREATMENT,17,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,388.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,388.81,388.81,
COMPLEX WOUND REPAIR AND TREATMENT,18,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1034.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1034.3,1034.3,
MOHS MICROGRAPHIC SURGERY,19,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,960.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,960.88,960.88,
"BREAST BIOPSIES, EXCISIONS, AND OTHER RELATED PROCEDURES",20,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1354.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1354.87,1354.87,
LEVEL I MASTECTOMY AND RECONSTRUCTIVE BREAST PROCEDURES,21,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3313.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3313.1,3313.1,
LEVEL II MASTECTOMY AND RECONSTRUCTIVE BREAST PROCEDURES,22,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7356.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7356.28,7356.28,
LEVEL I FOREARM AND WRIST PROCEDURES,23,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1730.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1730.4,1730.4,
LEVEL II FOREARM AND WRIST PROCEDURES,24,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5581.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5581.44,5581.44,
LEVEL I SHOULDER AND UPPER ARM PROCEDURES,25,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4781.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4781.07,4781.07,
LEVEL I KNEE AND LOWER LEG PROCEDURES,26,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3185.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3185.99,3185.99,
LEVEL I HIP AND FEMUR PROCEDURES,27,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4233.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4233.82,4233.82,
LEVEL I SPINE PROCEDURES,28,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5025.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5025.68,5025.68,
LEVEL II SPINE PROCEDURES,29,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11702.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11702.59,11702.59,
LEVEL I HAND PROCEDURES,33,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1328.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1328.67,1328.67,
LEVEL II HAND PROCEDURES,34,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2191.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2191.18,2191.18,
LEVEL I FOOT PROCEDURES,35,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2176.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2176.63,2176.63,
LEVEL II FOOT PROCEDURES,36,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5549.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5549.86,5549.86,
LEVEL I ARTHROSCOPY,37,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2178.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2178.5,2178.5,
LEVEL II ARTHROSCOPY,38,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5494.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5494.19,5494.19,
CAST APPLICATION OR REPLACEMENT,39,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,183.14,
MINOR SPLINT AND STRAPPING APPLICATION,40,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,77.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,77.11,77.11,
CLOSED TREATMENT FX AND DISLOCATION,41,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,468.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,468.45,468.45,
OPEN OR PERCUTANEOUS TREATMENT OF FRACTURES,43,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5372.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5372.52,5372.52,
BONE OR JOINT MANIPULATION UNDER ANESTHESIA,44,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.98,982.98,
LEVEL I ARTHROPLASTY,46,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3449.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3449.14,3449.14,
LEVEL II ARTHROPLASTY,47,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9662.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9662.73,9662.73,
"LEVEL I JOINT, TENDON, OR LIGAMENT INJECTION PROCEDURES",49,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.71,250.71,
"LEVEL II JOINT, TENDON, OR LIGAMENT INJECTION PROCEDURES",50,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,467.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,467.3,467.3,
"MUSCULOSKELETAL EXCISIONS, BIOPSIES, AND DRAINAGE PROCEDURES",51,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1822.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1822.54,1822.54,
LEVEL II KNEE AND LOWER LEG PROCEDURES,52,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7465.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7465.94,7465.94,
SPINE INJECTIONS AND OTHER RELATED PROCEDURES,53,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,778.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,778.04,778.04,
FIXATION DEVICE INSERTION OR REPLACEMENT PROCEDURES,54,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2357.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2357.72,2357.72,
LEVEL II HIP AND FEMUR PROCEDURES,55,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11920.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11920.33,11920.33,
SKIN AND CONNECTIVE TISSUE GRAFTING AND FLAP PROCEDURES,56,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1977.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1977.48,1977.48,
LEVEL III SPINE PROCEDURES,57,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16952.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16952.29,16952.29,
LEVEL II SHOULDER AND UPPER ARM PROCEDURES,58,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9102.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9102.98,9102.98,
ARTERIOVENOUS FISTULA CREATION OR REVISION FOR HEMODIALYSIS,59,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3583.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3583.49,3583.49,
PULMONARY FUNCTION TESTS,60,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.07,105.07,
LEVEL I ENDOSCOPY OF THE UPPER AIRWAY,62,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,614.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,614.88,614.88,
LEVEL II ENDOSCOPY OF THE UPPER AIRWAY,63,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1916.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1916.92,1916.92,
LEVEL I LOWER AIRWAY ENDOSCOPY,64,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1825.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1825.26,1825.26,
PULMONARY REHABILITATIVE SERVICES,66,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,34.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,34.78,34.78,
VENTILATION ASSISTANCE AND MANAGEMENT,67,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1076.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1076.93,1076.93,
"THORACENTESIS, RELATED BIOPSY AND PLEURAL DRAINAGE PROCEDURES",68,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1014.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1014.62,1014.62,
LEVEL I THORACIC AND CHEST PROCEDURES,69,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2358.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2358.14,2358.14,
LEVEL II THORACIC AND CHEST PROCEDURES,70,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5143,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5143,5143,
LEVEL II LOWER AIRWAY ENDOSCOPY,71,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3718.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3718.81,3718.81,
TRACHEOSTOMY AND RELATED TRACHEAL PROCEDURES,72,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2093.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2093.78,2093.78,
DIAPHRAGMATIC PROCEDURES AND RELATED HERNIA REPAIR,73,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6534.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6534.65,6534.65,
"REVISION, REPLACEMENT OR REMOVAL OF CARDIAC DEVICE COMPONENT",74,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1597.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1597.49,1597.49,
LEVEL I CENTRAL VENOUS ACCESS PROCEDURES,75,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1117.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1117.45,1117.45,
"REVISION, REPAIR OR REMOVAL OF CENTRAL VENOUS ACCESS DEVICE",76,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,750.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,750.68,750.68,
LEVEL I PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES,77,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3752.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3752.26,3752.26,
"LEVEL I PERIPHERAL VASCULAR REPAIR, LIGATION OR RECONSTRUCTION",78,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2133.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2133.21,2133.21,
LEVEL II PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES,79,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6292.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6292.21,6292.21,
EXERCISE TOLERANCE TESTS,80,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.77,168.77,
ECHOCARDIOGRAPHY,81,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,441.04,
COMPREHENSIVE CARDIAC ELECTROPHYSIOLOGIC PROCEDURES WITH ABLATION,82,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17800.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17800.01,17800.01,
LEVEL II CENTRAL VENOUS ACCESS PROCEDURES,83,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2158.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2158.09,2158.09,
CARDIAC CATHETERIZATION PROCEDURES,84,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2456.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2456.93,2456.93,
LEVEL III PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES,85,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10894.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10894.19,10894.19,
PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT,86,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8013.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8013.67,8013.67,
REMOVAL OR REVISION OF PACEMAKERS AND OTHER CARDIOVASCULAR DEVICES,87,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7358.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7358.7,7358.7,
LEVEL I VARICOSE VEIN AND RELATED PROCEDURES,90,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,646.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,646.76,646.76,
"LEVEL II PERIPHERAL VASCULAR REPAIR, LIGATION OR RECONSTRUCTION",91,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4069.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4069.63,4069.63,
RESUSCITATION,92,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,715.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,715.84,715.84,
CARDIOVERSION,93,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,631.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,631.12,631.12,
CARDIAC REHABILITATION,94,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.93,158.93,
CARDIAC ELECTROPHYSIOLOGIC PROCEDURES INCLUDING PACING AND RECORDING,96,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6488.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6488.58,6488.58,
AICD AND RELATED CARDIAC DEVICE INSERTION OR REPLACEMENT,97,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,22573.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,22573.23,22573.23,
LEVEL I PERCUTANEOUS CORONARY AND INTRACARDIAC INTERVENTIONAL PROCEDURES,99,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8351.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8351.82,8351.82,
CONSULTATIVE TELEHEALTH ASSESSMENTS MEDICAL VISIT INDICATOR,102,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
LEVEL II VARICOSE VEIN AND RELATED PROCEDURES,103,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2770.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2770.13,2770.13,
MAJOR OPEN CORONARY ARTERY PROCEDURES INCLUDING CABG,104,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,17766.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,17766.68,17766.68,
MAJOR OPEN CARDIAC AND CARDIAC VALVE PROCEDURES,105,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11053.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11053.84,11053.84,
MAJOR OPEN ABDOMINAL AND THORACIC VASCULAR PROCEDURES,106,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9703.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9703.43,9703.43,
CHOLECYSTECTOMY AND RELATED BILIARY PROCEDURES,107,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3496.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3496.84,3496.84,
OTHER INTRA-ABDOMINAL AND INTRAPERITONEAL SURGICAL PROCEDURES,108,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3722.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3722.67,3722.67,
ANCILLARY DRUG ADMINISTRATION,109,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.16,47.16,
PHARMACOTHERAPY BY EXTENDED INFUSION,110,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,469.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,469.96,469.96,
PHARMACOTHERAPY EXCEPT BY EXTENDED INFUSION,111,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,300.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,300.04,300.04,
LEVEL I BLOOD PRODUCT EXCHANGE SERVICES,113,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,411.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,411.27,411.27,
LEVEL II BLOOD PRODUCT EXCHANGE SERVICES,114,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1665.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1665.61,1665.61,
DEEP LYMPH STRUCTURE PROCEDURES,115,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3236.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3236.59,3236.59,
LEVEL I ALLERGY TESTS,116,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.44,35.44,
HOME INFUSION,117,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
NUTRITION THERAPY,118,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,169.07,
CAR T-CELL IMMUNOTHERAPY PREPARATION SERVICES,119,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,610.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,610.11,610.11,
CAR T-CELL IMMUNOTHERAPY,120,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,45670.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,45670.34,45670.34,
LEVEL II PERCUTANEOUS CORONARY AND INTRACARDIAC INTERVENTIONAL PROCEDURES,121,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14693.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14693.91,14693.91,
PERCUTANEOUS INTRA-ABDOMINAL OR INTRATHORACIC VASCULAR PROCEDURES,122,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16718.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16718.55,16718.55,
PERIPHERAL VASCULAR BYPASS PROCEDURES,123,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5634.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5634.34,5634.34,
BONE MARROW BIOPSIES,124,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1687.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1687.22,1687.22,
LEVEL I ESOPHAGEAL AND GASTRIC SURGICAL PROCEDURES,125,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3308.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3308.33,3308.33,
LEVEL II ESOPHAGEAL AND GASTRIC SURGICAL PROCEDURES,126,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3608.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3608.97,3608.97,
LEVEL I SMALL AND LARGE INTESTINE SURGICAL PROCEDURES,127,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2099.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2099.28,2099.28,
LEVEL II SMALL AND LARGE INTESTINE SURGICAL PROCEDURES,128,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3887.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3887.46,3887.46,
ESOPHAGOGASTRIC RESTRICTIVE PROCEDURES AND GASTRIC FUNDOPLICATION,129,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5119.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5119.7,5119.7,
MINOR GASTROINTESTINAL PROCEDURES INCLUDING TUBE INSERTION OR PLACEMENT,130,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,396.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,396.17,396.17,
LEVEL I UPPER GI ENDOSCOPY,134,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,982.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,982.25,982.25,
LEVEL II UPPER GI ENDOSCOPY,135,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2042.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2042.21,2042.21,
LEVEL I LOWER GI ENDOSCOPY,136,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1003.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1003.69,1003.69,
LEVEL II LOWER GI ENDOSCOPY,137,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2063.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2063.35,2063.35,
LEVEL I ERCP AND RELATED ENDOSCOPIC PROCEDURES,138,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2608.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2608.37,2608.37,
LEVEL I ANAL AND RECTAL PROCEDURES,141,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1464.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1464.71,1464.71,
LEVEL II ANAL AND RECTAL PROCEDURES,142,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2291.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2291.05,2291.05,
ABDOMINAL PARACENTESIS AND RELATED PERITONEAL DRAINAGE PROCEDURES,150,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,734.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,734.8,734.8,
LEVEL I HEPATOBILIARY AND PANCREAS PROCEDURES,151,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2255.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2255.97,2255.97,
LEVEL II HEPATOBILIARY AND PANCREAS PROCEDURES,152,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5521.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5521.85,5521.85,
LEVEL II ERCP AND RELATED ENDOSCOPIC PROCEDURES,153,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4338.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4338.94,4338.94,
LEVEL III UPPER GI ENDOSCOPY,154,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3821.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3821.82,3821.82,
LEVEL III BLOOD PRODUCT EXCHANGE SERVICES,155,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4518.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4518.95,4518.95,
OCULAR IMAGING AND RELATED SERVICES,156,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57,57,
REPRODUCTIVE PATHOLOGY TESTS,157,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,99.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,99.15,99.15,
PATHOLOGY CONSULTATION AND INTERPRETATION,158,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,85.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,85.08,85.08,
MINOR UROLOGY SERVICES,159,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,87.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,87.74,87.74,
URINARY STUDIES AND PROCEDURES,161,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,410.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,410.97,410.97,
LEVEL I URETHRAL PROCEDURES,166,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2917.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2917.89,2917.89,
LEVEL II URETHRAL PROCEDURES,167,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5822.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5822.68,5822.68,
DIALYSIS PROCEDURES,168,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,791.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,791.44,791.44,
LEVEL I KIDNEY AND URETERAL PROCEDURES,170,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1491.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1491.22,1491.22,
LEVEL II KIDNEY AND URETERAL PROCEDURES,171,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2948.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2948.5,2948.5,
LEVEL III KIDNEY AND URETERAL PROCEDURES,172,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6939.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6939.64,6939.64,
LEVEL I BLADDER AND URETERAL PROCEDURES,173,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1585.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1585.78,1585.78,
LEVEL II BLADDER AND URETERAL PROCEDURES,174,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4129.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4129.29,4129.29,
LEVEL III BLADDER AND URETERAL PROCEDURES,175,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4979.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4979.06,4979.06,
LEVEL I PROSTATE PROCEDURES,176,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1733.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1733.84,1733.84,
MINOR DERMATOLOGY SERVICES,177,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.68,28.68,
ANTEPARTUM PROCEDURES,178,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,587.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,587.59,587.59,
ECTOPIC PREGNANCY PROCEDURES,179,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3672.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3672.56,3672.56,
TESTICULAR AND EPIDIDYMAL PROCEDURES,180,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2409.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2409.89,2409.89,
INSERTION OF PENILE PROSTHESIS,182,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,13468.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,13468.68,13468.68,
LEVEL I PENILE PROCEDURES,183,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2007.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2007.19,2007.19,
LEVEL II PROSTATE PROCEDURES,184,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4481.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4481.93,4481.93,
LEVEL II PENILE PROCEDURES,187,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3108.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3108.58,3108.58,
LEVEL I PERINEAL AND VAGINAL GYNECOLOGICAL PROCEDURES,188,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2481.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2481.02,2481.02,
LEVEL II PERINEAL AND VAGINAL GYNECOLOGICAL PROCEDURES,189,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5642.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5642.73,5642.73,
ARTIFICIAL FERTILIZATION,190,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,416.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,416.04,416.04,
LEVEL I FETAL PROCEDURES,191,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.09,197.09,
LEVEL II FETAL PROCEDURES,192,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1015.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1015.34,1015.34,
ABORTION AND MISCARRIAGE TREATMENT AND PROCEDURES,194,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1761.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1761.13,1761.13,
VAGINAL DELIVERY PROCEDURES,195,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2193.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2193.47,2193.47,
CESAREAN DELIVERY PROCEDURES,202,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2634.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2634.51,2634.51,
GLOBAL ANTEPARTUM AND POSTPARTUM VISITS,203,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,249.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,249.02,249.02,
LEVEL I HYSTERECTOMY AND MYOMECTOMY PROCEDURES,204,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4191.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4191.91,4191.91,
OBSTETRICAL PROCEDURES,205,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724.96,1724.96,
LEVEL II HYSTERECTOMY AND MYOMECTOMY PROCEDURES,206,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5926.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5926.84,5926.84,
LEVEL I OTHER UTERINE AND ADNEXA GYNECOLOGICAL PROCEDURES,207,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2367.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2367.08,2367.08,
LEVEL II OTHER UTERINE AND ADNEXA GYNECOLOGICAL PROCEDURES,208,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4314.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4314.49,4314.49,
OTHER GYNECOLOGICAL PROCEDURES,209,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,541.58,
EXTENDED EEG STUDIES,210,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,456.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,456.44,456.44,
ELECTROENCEPHALOGRAM,211,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,337.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,337.48,337.48,
ELECTROCONVULSIVE THERAPY,212,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,499.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,499.31,499.31,
NERVE AND MUSCLE TESTS,213,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.02,135.02,
LEVEL I NERVOUS SYSTEM INJECTIONS INCLUDING CRANIAL TAP,214,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.26,406.26,
LEVEL I PERIPHERAL NERVE PROCEDURES,217,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1371.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1371.3,1371.3,
LEVEL II PERIPHERAL NERVE PROCEDURES,218,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4864.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4864.82,4864.82,
LEVEL II NERVOUS SYSTEM INJECTIONS INCLUDING CRANIAL TAP,220,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1303.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1303.19,1303.19,
SLEEP STUDIES ATTENDED,222,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,805.03,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,805.03,805.03,
LEVEL I NEUROSTIMULATOR AND RELATED DEVICE IMPLANTATION,223,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,6227.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,6227.48,6227.48,
LEVEL II NEUROSTIMULATOR AND RELATED DEVICE IMPLANTATION,224,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,19217.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,19217.86,19217.86,
OTHER INTRACRANIAL NEUROSURGERY PROCEDURES,225,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3857.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3857.39,3857.39,
SLEEP STUDIES UNATTENDED,226,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.64,154.64,
LEVEL I CRANIOFACIAL BONE PROCEDURES,227,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2662.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2662.65,2662.65,
LEVEL II CRANIOFACIAL BONE PROCEDURES,228,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5078.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5078.39,5078.39,
MINOR AUDIOMETRY TESTS AND AUDIOLOGY SCREENING SERVICES,229,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.1,31.1,
MINOR OPHTHALMOLOGICAL PROCEDURES AND DIAGNOSTIC SERVICES,230,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,294.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,294.25,294.25,
CATARACT AND OTHER INTRAOCULAR LENS PROCEDURES,233,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1738.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1738.31,1738.31,
LEVEL I ANTERIOR CHAMBER EYE PROCEDURES,234,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1026.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1026.33,1026.33,
LEVEL II ANTERIOR CHAMBER EYE PROCEDURES,235,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3386.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3386.7,3386.7,
"LEVEL I INTRAVITREAL, RETINAL AND OTHER POSTERIOR CHAMBER EYE PROCEDURES",237,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1044.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1044.69,1044.69,
"LEVEL II INTRAVITREAL, RETINAL AND OTHER POSTERIOR CHAMBER EYE PROCEDURES",238,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3181.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3181.64,3181.64,
EXTRAOCULAR MUSCLE PROCEDURES,239,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2156.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2156.7,2156.7,
OCULAR RECONSTRUCTIVE PROCEDURES W OR W/O OCULAR DEVICE,241,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2867.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2867.65,2867.65,
CLASS I THERAPEUTIC RADIOPHARMACEUTICALS,243,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
CLASS II THERAPEUTIC RADIOPHARMACEUTICALS,244,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,406.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,406.8,406.8,
CLASS III THERAPEUTIC RADIOPHARMACEUTICALS,245,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12562.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12562.02,12562.02,
CLASS IV THERAPEUTIC RADIOPHARMACEUTICALS,246,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36642.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36642.41,36642.41,
LEVEL I CORNEAL AND OTHER ANTERIOR SURFACE EYE PROCEDURES,247,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,579.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,579.56,579.56,
LEVEL II CORNEAL AND OTHER ANTERIOR SURFACE EYE PROCEDURES,248,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3234.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3234.54,3234.54,
"MINOR EAR, NOSE, MOUTH AND THROAT PROCEDURES",249,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.51,172.51,
COCHLEAR DEVICE IMPLANTATION,250,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,24228.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,24228.39,24228.39,
OTORHINOLARYNGOLOGIC FUNCTION TESTS,251,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.21,140.21,
"LEVEL I EAR, NOSE, MOUTH AND THROAT PROCEDURES",252,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1424.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1424.62,1424.62,
"LEVEL II EAR, NOSE, MOUTH AND THROAT PROCEDURES",253,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2580.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2580.47,2580.47,
"LEVEL III EAR, NOSE, MOUTH AND THROAT PROCEDURES",254,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3373.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3373.18,3373.18,
"LEVEL IV EAR, NOSE, MOUTH AND THROAT PROCEDURES",255,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4472.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4472.57,4472.57,
TONSIL AND ADENOID PROCEDURES,256,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2021.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2021.38,2021.38,
AUDIOMETRY,257,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,81.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,81.34,81.34,
"LEVEL I EYELID, LACRIMAL AND CONJUNCTIVAL PROCEDURES",258,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1346.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1346.96,1346.96,
"LEVEL II EYELID, LACRIMAL AND CONJUNCTIVAL PROCEDURES",259,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1745.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1745.49,1745.49,
CASE MANAGEMENT AND CARE PLANNING SERVICES,260,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,110.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,110.74,110.74,
ESRD MONTHLY CASE MANAGEMENT,261,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,606.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,606.91,606.91,
CLEFT LIP AND PALATE REPAIR,262,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2717.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2717.78,2717.78,
THYROID AND PARATHYROID PROCEDURES,263,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4398.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4398.48,4398.48,
MAJOR CRANIOTOMY AND CRANIECTOMY SURGICAL PROCEDURES,264,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3810.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3810.29,3810.29,
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,265,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14318.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14318.81,14318.81,
OPEN INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,266,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4231.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4231.94,4231.94,
OTHER CRANIOTOMY PROCEDURES INCLUDING CRANIOPLASTY,267,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5431.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5431.82,5431.82,
CRANIAL AND SPINAL SHUNT PROCEDURES,268,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5861.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5861.14,5861.14,
LEVEL II ANCILLARY THERAPEUTIC SERVICES,269,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.71,36.71,
OCCUPATIONAL THERAPY,270,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.46,211.46,
PHYSICAL THERAPY,271,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,192.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,192.98,192.98,
SPEECH THERAPY AND EVALUATION,272,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,231.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,231.99,231.99,
PROCEDURES FOR REVISION OR REMOVAL OF NEUROSTIMULATOR DEVICES,276,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3398.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3398.66,3398.66,
LEVEL I VASCULAR RADIOLOGICAL PROCEDURES,277,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1093.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1093.96,1093.96,
INJECTION(S) FOR RADIOLOGICAL IMAGING,278,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,333.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,333.62,333.62,
LEVEL II VASCULAR RADIOLOGICAL PROCEDURES,279,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1724,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1724,1724,
LEVEL III VASCULAR RADIOLOGICAL PROCEDURES,280,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4501.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4501.62,4501.62,
MAGNETIC RESONANCE ANGIOGRAPHY,282,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,500.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,500.76,500.76,
MYELOGRAPHY AND DISCOGRAPHY IMAGING PROCEDURES,284,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,569.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,569.47,569.47,
MAMMOGRAPHY AND OTHER RELATED PROCEDURES,286,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,48.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,48.61,48.61,
LEVEL I DIAGNOSTIC ULTRASOUND,288,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,111.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,111.29,111.29,
LEVEL II DIAGNOSTIC ULTRASOUND,289,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.49,171.49,
PET SCANS,290,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1358.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1358.86,1358.86,
BONE DENSITY AND RELATED PROCEDURES,291,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,80.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,80.31,80.31,
MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST,293,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.76,245.76,
MAGNETIC RESONANCE IMAGING WITH CONTRAST,295,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,414.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,414.59,414.59,
MAGNETOCEPHALOGRAPHY,297,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2369.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2369.49,2369.49,
LEVEL I COMPUTED TOMOGRAPHY,299,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,108.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,108.69,108.69,
LEVEL II COMPUTED TOMOGRAPHY,300,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.58,309.58,
COMPUTED TOMOGRAPHY- OTHER,301,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,262.91,
COMPUTED TOMOGRAPHIC ANGIOGRAPHY,302,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,378.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,378.3,378.3,
MINOR SPECIMEN COLLECTION SERVICES,304,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.78,2.78,
LEVEL I SURGICAL PATHOLOGY TESTS,305,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,32.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,32.85,32.85,
LEVEL II SURGICAL PATHOLOGY TESTS,306,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,133.99,
INSERTION OR REMOVAL OF DRUG DELIVERY DEVICE,307,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.07,326.07,
LEVEL III PATHOLOGY TESTS,308,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,150.53,
ADAPTIVE BEHAVIORAL HEALTH TREATMENT SERVICES,309,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.26,44.26,
DEVELOPMENTAL AND NEUROPSYCHOLOGICAL TESTING,310,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,594.71,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,594.71,594.71,
BEHAVIORAL AND SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM,312,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,362.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,362.12,362.12,
COUNSELLING OR INDIVIDUAL BRIEF PSYCHOTHERAPY,315,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,131.7,
INDIVIDUAL COMPREHENSIVE PSYCHOTHERAPY,316,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.42,157.42,
FAMILY PSYCHOTHERAPY,317,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.67,171.67,
GROUP PSYCHOTHERAPY,318,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.9,239.9,
ACTIVITY THERAPY,319,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.94,156.94,
BEHAVIORAL HEALTH - CASE MANAGEMENT AND TREATMENT PLAN DEVELOPMENT,320,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,100.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,100.84,100.84,
CRISIS INTERVENTION,321,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.67,187.67,
MEDICATION ADMINISTRATION AND OBSERVATION,322,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,44.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,44.2,44.2,
BEHAVIORAL HEALTH ASSESSMENT,323,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.94,252.94,
SCREENING FOR BEHAVIORAL CHANGE OR RISK ASSESSMENT,324,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.49,23.49,
PREVENTION COUNSELING,325,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.55,73.55,
INTENSIVE OUTPATIENT PSYCHIATRIC TREATMENT,327,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,353.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,353.18,353.18,
"DAY REHABILITATION, HALF DAY",328,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,319.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,319.61,319.61,
"DAY REHABILITATION, FULL DAY",329,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,476.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,476.18,476.18,
LEVEL I DIAGNOSTIC NUCLEAR MEDICINE,331,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,374.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,374.25,374.25,
LEVEL II DIAGNOSTIC NUCLEAR MEDICINE,332,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,896.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,896.39,896.39,
BEHAVIORAL HEALTH RESIDENTIAL TREATMENT,333,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,529.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,529.08,529.08,
CLASS I BRACHYTHERAPY SOURCES,335,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.49,260.49,
CLASS II BRACHYTHERAPY SOURCES,336,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3437.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3437.24,3437.24,
CLASS III BRACHYTHERAPY SOURCES,337,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11410.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11410.34,11410.34,
THERAPEUTIC NUCLEAR MEDICINE,340,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,276.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,276.8,276.8,
LEVEL I RADIATION THERAPY,343,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.14,183.14,
RADIOSURGERY,346,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,5535.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,5535.8,5535.8,
LEVEL II RADIATION THERAPY,347,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.43,481.43,
LEVEL III RADIATION THERAPY,348,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1449.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1449.07,1449.07,
ADJUNCTIVE DENTAL SERVICES,350,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,235.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,235.92,235.92,
LEVEL I PERIODONTICS,352,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1075.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1075.84,1075.84,
"LEVEL I PROSTHODONTICS, FIXED",353,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,104.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,104.1,104.1,
"LEVEL II PROSTHODONTICS, FIXED",354,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,389.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,389.41,389.41,
"LEVEL III PROSTHODONTICS, FIXED",355,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,481.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,481.74,481.74,
"LEVEL I PROSTHODONTICS, REMOVABLE",356,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.98,210.98,
"LEVEL II PROSTHODONTICS, REMOVABLE",357,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,260.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,260.85,260.85,
"LEVEL III PROSTHODONTICS, REMOVABLE",358,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.67,310.67,
LEVEL I MAXILLOFACIAL PROSTHETICS,359,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1553.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1553.29,1553.29,
LEVEL II MAXILLOFACIAL PROSTHETICS,360,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3495.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3495.63,3495.63,
LEVEL I DENTAL RESTORATIONS,361,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2041.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2041.97,2041.97,
LEVEL II DENTAL RESTORATIONS,362,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2527.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2527.39,2527.39,
LEVEL III DENTAL RESTORATIONS,363,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2780.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2780.16,2780.16,
LEVEL I ENDODONTICS,364,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,142.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,142.99,142.99,
LEVEL II ENDODONTICS,365,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.17,257.17,
LEVEL III ENDODONTICS,366,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.38,306.38,
LEVEL I ORAL SURGERY PROCEDURES,367,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1218.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1218.53,1218.53,
LEVEL II ORAL SURGERY PROCEDURES,368,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1851.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1851.1,1851.1,
LEVEL III ORAL SURGERY PROCEDURES,369,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2876.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2876.59,2876.59,
LEVEL I ORTHODONTICS,371,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1374.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1374.02,1374.02,
SEALANT,372,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.21,42.21,
LEVEL I DENTAL IMAGING,373,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,31.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,31.28,31.28,
LEVEL II DENTAL IMAGING,374,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.56,119.56,
DENTAL ANESTHESIA,375,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.69,35.69,
DIAGNOSTIC DENTAL PROCEDURES,376,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,107.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,107.18,107.18,
PREVENTIVE DENTAL PROCEDURES,377,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.55,112.55,
LEVEL II PERIODONTICS,378,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1141.6,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1141.6,1141.6,
LEVEL II ORTHODONTICS,379,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1511.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1511.45,1511.45,
ANESTHESIA,380,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.19,23.19,
LEVEL I DENTAL IMPLANTS,381,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1318.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1318.7,1318.7,
LEVEL II DENTAL IMPLANTS,382,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1450.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1450.58,1450.58,
LEVEL III CHEMISTRY TESTS,384,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,56.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,56.28,56.28,
"LEVEL I COMPLEX LABORATORY, MOLECULAR PATHOLOGY AND GENETIC TESTS",385,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.46,38.46,
"LEVEL II COMPLEX LABORATORY, MOLECULAR PATHOLOGY AND GENETIC TESTS",386,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.04,136.04,
"LEVEL III COMPLEX LABORATORY, MOLECULAR PATHOLOGY AND GENETIC TESTS",387,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,296.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,296.78,296.78,
LEVEL III MICROBIOLOGY TESTS,388,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,168.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,168.47,168.47,
LEVEL II CONVENTIONAL RADIOLOGY,389,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.52,120.52,
LEVEL I PATHOLOGY TESTS,390,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.11,4.11,
LEVEL II PATHOLOGY TESTS,391,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,27.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,27.11,27.11,
PAP SMEARS,392,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16.91,16.91,
LEVEL II BLOOD AND TISSUE TYPING TESTS,393,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,51.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,51.57,51.57,
LEVEL I IMMUNOLOGY TESTS,394,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.54,9.54,
LEVEL II IMMUNOLOGY TESTS,395,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,33.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,33.69,33.69,
LEVEL I MICROBIOLOGY TESTS,396,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8.7,8.7,
LEVEL II MICROBIOLOGY TESTS,397,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,35.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,35.38,35.38,
LEVEL I ENDOCRINOLOGY TESTS,398,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.93,10.93,
LEVEL II ENDOCRINOLOGY TESTS,399,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.86,28.86,
LEVEL I CHEMISTRY TESTS,400,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,9.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,9.9,9.9,
LEVEL II CHEMISTRY TESTS,401,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,23.25,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,23.25,23.25,
BASIC CHEMISTRY TESTS,402,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.47,4.47,
ORGAN OR DISEASE ORIENTED PANELS,403,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7.49,7.49,
TOXICOLOGY TESTS,404,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.14,10.14,
THERAPEUTIC DRUG MONITORING,405,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,10.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,10.02,10.02,
LEVEL I CLOTTING TESTS,406,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,3.62,
LEVEL II CLOTTING TESTS,407,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,20.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,20.95,20.95,
LEVEL I HEMATOLOGY TESTS,408,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4.89,4.89,
LEVEL II HEMATOLOGY TESTS,409,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12.26,12.26,
URINALYSIS,410,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2.48,2.48,
ANCILLARY RESPIRATORY THERAPY AND OTHER PULMONARY TESTS AND SERVICES,412,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,58.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,58.69,58.69,
CARDIOGRAM,413,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,26.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,26.21,26.21,
LEVEL I IMMUNIZATION,414,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21.68,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21.68,21.68,
LEVEL II IMMUNIZATION,415,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.61,114.61,
MINOR FEMALE REPRODUCTIVE PROCEDURES,417,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.14,215.14,
AMBULATORY PATIENT MONITORING AND RELATED ASSESSMENTS,418,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,62.92,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,62.92,62.92,
ANCILLARY OPHTHALMOLOGY OR OPTOMETRY SERVICES,419,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.69,76.69,
"ELECTRONIC ANALYSIS FOR CARDIAC, NEUROLOGICAL AND OTHER DEVICES",420,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.04,145.04,
VASCULAR ACCESS BY NEEDLE OR CATHETER,423,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,696.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,696.46,696.46,
BIOFEEDBACK AND OTHER TRAINING,427,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,89.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,89.73,89.73,
"PATIENT EDUCATION, INDIVIDUAL",428,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,73.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,73.18,73.18,
"PATIENT EDUCATION, GROUP",429,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,38.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,38.4,38.4,
CLASS I CHEMOTHERAPY DRUGS,430,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
CLASS II CHEMOTHERAPY DRUGS,431,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.53,36.53,
CLASS III CHEMOTHERAPY DRUGS,432,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.56,126.56,
CLASS IV CHEMOTHERAPY DRUGS,433,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,298.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,298.41,298.41,
CLASS V CHEMOTHERAPY DRUGS,434,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.62,324.62,
CLASS I PHARMACOTHERAPY,435,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
CLASS II PHARMACOTHERAPY,436,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,98.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,98.73,98.73,
CLASS III PHARMACOTHERAPY,437,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.99,117.99,
CLASS IV PHARMACOTHERAPY,438,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.72,191.72,
CLASS V PHARMACOTHERAPY,439,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,462.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,462.72,462.72,
CLASS VI PHARMACOTHERAPY,440,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,563.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,563.74,563.74,
CLASS VI CHEMOTHERAPY DRUGS,441,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,591.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,591.87,591.87,
CLASS VII CHEMOTHERAPY DRUGS,443,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,940.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,940.59,940.59,
CLASS VII PHARMACOTHERAPY,444,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,984.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,984.97,984.97,
EXPANDED HOURS ACCESS,448,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,28.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,28.62,28.62,
ADDITIONAL UNDIFFERENTIATED MEDICAL VISITS/SERVICES,449,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
OBSERVATION,450,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,712.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,712.76,712.76,
DIABETES SUPPLIES,452,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
MOTORIZED WHEELCHAIR,453,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
TPN FORMULAE,454,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL BIOLOGICAL AND SYNTHETIC APPLICATION PRODUCTS,455,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
MOTORIZED WHEELCHAIR ACCESSORIES,456,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
ALLERGY THERAPY,458,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,25.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,25.54,25.54,
VACCINE ADMINISTRATION,459,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,39.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,39.55,39.55,
CLASS VIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,460,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1284.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1284.23,1284.23,
CLASS IX COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,461,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1823.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1823.63,1823.63,
CLASS X COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,462,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3626.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3626.36,3626.36,
CLASS XI COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,463,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4514.9,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4514.9,4514.9,
CLASS XII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,464,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7197.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7197.36,7197.36,
CLASS XIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,465,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,16059.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,16059.89,16059.89,
CLASS XIV COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,466,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,21869.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,21869.89,21869.89,
OBSTETRICAL ULTRASOUND,470,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,102.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,102.53,102.53,
LEVEL I CONVENTIONAL RADIOLOGY,471,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.18,57.18,
ULTRASOUND GUIDANCE,472,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.49,114.49,
CT GUIDANCE,473,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,83.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,83.87,83.87,
RADIOLOGICAL GUIDANCE FOR THERAPEUTIC OR DIAGNOSTIC PROCEDURES,474,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.91,205.91,
MRI GUIDANCE,475,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.15,222.15,
LEVEL I RADIATION TREATMENT PREPARATION AND PLANNING,476,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.34,122.34,
LEVEL II RADIATION TREATMENT PREPARATION AND PLANNING,477,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.97,189.97,
LEVEL III RADIATION TREATMENT PREPARATION AND PLANNING,478,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1084,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1084,1084,
RADIATION THERAPY MANAGEMENT,483,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,409.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,409.64,409.64,
CORNEAL TISSUE PROCESSING,485,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,2515.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,2515.62,2515.62,
LEVEL I BLOOD AND TISSUE TYPING TESTS,486,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3.62,3.62,
MINOR DEVICE EVALUATION AND INTERROGATION,488,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,36.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,36.83,36.83,
INCIDENTAL SERVICES FOR QUALITY OR PERFORMANCE MEASUREMENT,490,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
MEDICAL VISIT INDICATOR,491,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
LEVEL I ANCILLARY THERAPEUTIC SERVICES,493,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30.86,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30.86,30.86,
COMPLEX BLOOD COLLECTION SERVICES,494,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,76.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,76.51,76.51,
MINOR CHEMOTHERAPY DRUGS,495,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
MINOR PHARMACOTHERAPY,496,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
TELEHEALTH FACILITATION,497,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,14.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,14.31,14.31,
PEN FORMULAE,498,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
"BLOOD PROCESSING, STORAGE AND RELATED SERVICES",499,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.29,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.29,86.29,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,518,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.73,187.73,
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM,519,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.39,133.39,
SPINAL DIAGNOSES AND INJURIES,520,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.09,163.09,
NERVOUS SYSTEM MALIGNANCY,521,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.83,145.83,
DEGENERATIVE NERVOUS SYSTEM DIAGNOSES EXC MULT SCLEROSIS,522,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.96,134.96,
MULTIPLE SCLEROSIS AND OTHER DEMYELINATING DISEASES,523,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.89,120.89,
OTHER CENTRAL NERVOUS SYSTEM DIAGNOSES,524,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.01,162.01,
TRANSIENT ISCHEMIA,526,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.28,252.28,
"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DIAGNOSES",527,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,137.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,137.61,137.61,
ANOXIC AND OTHER SEVERE BRAIN DAMAGE OR COMA,528,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.88,211.88,
SEIZURE,529,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,197.69,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,197.69,197.69,
HEADACHES OTHER THAN MIGRAINE,530,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.85,178.85,
MIGRAINE,531,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,131.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,131.7,131.7,
HEAD TRAUMA WITH OR WITHOUT LOC/COMA LESS THAN 1 HR,532,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.97,237.97,
AFTEREFFECTS OF CEREBROVASCULAR ACCIDENT,533,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,162.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,162.61,162.61,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION W/O INFARC,534,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,126.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,126.62,126.62,
CVA AND PRECEREBRAL OCCLUSION W INFARCT,535,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.79,237.79,
CEREBRAL PALSY,536,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.18,164.18,
"MALFUNCTION, REACTION, COMPLICATION OF NEUROLOGICAL DEVICE OR PROC",537,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.79,205.79,
HEAD TRAUMA WITH LOC/COMA MORE THEN 1 HR,538,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,556.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,556.01,556.01,
INTRACRANIAL HEMORRHAGE,539,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,306.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,306.93,306.93,
"PERIPHERAL, CRANIAL, AND AUTONOMIC NERVE INJURIES",545,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.05,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.05,184.05,
PERIPHERAL AND OTHER VASCULAR RELATED INJURIES,548,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.61,219.61,
ACUTE MAJOR EYE INFECTIONS,550,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,141.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,141.96,141.96,
CATARACTS,551,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,114.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,114.43,114.43,
GLAUCOMA,552,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.89,136.89,
OTHER OPHTHALMIC SYSTEM DIAGNOSES,553,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.12,155.12,
CONJUNCTIVITIS,555,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,121.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,121.07,121.07,
OCULAR AND PERIOCULAR MALIGNANCY,556,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,166.11,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,166.11,166.11,
OTHER EYE INFECTION DIAGNOSES,557,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,105.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,105.37,105.37,
"MALFUNCTION, REACTION, OR COMPLICATION OF OCULAR DEVICE OR PROCEDURE",558,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.95,136.95,
"EAR, NOSE, MOUTH, THROAT, CRANIAL AND FACIAL MALIGNANCIES",560,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.19,171.19,
VERTIGO AND OTHER LABYRINTH DISORDERS,561,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,232.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,232.54,232.54,
INFECTIONS OF UPPER RESPIRATORY TRACT AND OTITIS MEDIA,562,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,161.04,
DENTAL AND ORAL DIAGNOSES AND INJURIES,563,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.97,130.97,
"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIOFACIAL DIAGNOSES",564,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.63,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.63,158.63,
"MALFUNCTION, REACTION, OR COMPLICATION OF OTOLARYNGOLOGIC DEVICE OR PROCEDURE",566,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,147.33,
CYSTIC FIBROSIS - PULMONARY DISEASE,570,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,299.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,299.8,299.8,
RESPIRATORY MALIGNANCY,571,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.18,155.18,
BRONCHIOLITIS AND RSV PNEUMONIA,572,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,335.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,335.67,335.67,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,574,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.47,250.47,
ASTHMA,575,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.4,211.4,
OTHER RESPIRATORY SYSTEM DIAGNOSES,576,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.06,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.06,205.06,
STATUS ASTHMATICUS,579,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,318.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,318.16,318.16,
MAJOR CHEST AND RESPIRATORY TRAUMA,580,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,393.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,393.76,393.76,
PULMONARY INFECTION DIAGNOSES INCLUDING PNEUMONIA,581,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,310.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,310.73,310.73,
INTERSTITIAL AND ALVEOLAR LUNG DIAGNOSES,582,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,201.98,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,201.98,201.98,
"MALFUNCTION, REACTION, OR COMPLICATION OF PULMONARY DEVICE OR PROCEDURE",583,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,303.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,303.36,303.36,
ACUTE BRONCHITIS,584,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,269.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,269.49,269.49,
"AFTERCARE, OPEN WOUNDS AND OTHER TRAUMATIC INJURIES",585,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,122.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,122.52,122.52,
PULMONARY EMBOLISM,586,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,186.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,186.58,186.58,
RESPIRATORY FAILURE,587,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,412.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,412.96,412.96,
"MALFUNCTION, REACTION, OR COMPLICATION OF CARDIOVASCULAR DEVICE OR PROC",589,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,252.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,252.22,252.22,
ACUTE MYOCARDIAL INFARCTION,591,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,441.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,441.04,441.04,
OTHER CARDIOVASCULAR SYSTEM DIAGNOSES,592,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,193.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,193.83,193.83,
HEART FAILURE,594,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,210.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,210.74,210.74,
CARDIAC ARREST OR OTHER CAUSES OF MORTALITY,595,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.39,213.39,
PERIPHERAL AND OTHER VASCULAR DIAGNOSES,596,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,154.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,154.52,154.52,
PHLEBITIS,597,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.28,218.28,
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,598,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.77,134.77,
HYPERTENSION,599,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.81,140.81,
CARDIAC STRUCTURAL AND VALVULAR DIAGNOSES,600,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,136.47,
CARDIAC ARRHYTHMIA AND CONDUCTION DIAGNOSES,601,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.64,195.64,
ATRIAL FIBRILLATION,602,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.7,147.7,
CHEST PAIN,604,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,386.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,386.87,386.87,
SYNCOPE AND COLLAPSE,605,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,292.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,292.07,292.07,
CARDIOMYOPATHY DIAGNOSES,607,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,133.87,
ACUTE AND SUBACUTE ENDOCARDITIS,608,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.43,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.43,128.43,
CONTUSIONS TO EXTERNAL ORGANS OTHER THAN HEAD TRAUMA,610,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,263.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,263.45,263.45,
DIVERTICULITIS AND DIVERTICULOSIS,616,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,220.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,220.28,220.28,
GASTROINTESTINAL HEMORRHAGE AND RELATED POSTPROCEDURAL HEMORRHAGE DIAGNOSES,617,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,288.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,288.15,288.15,
INTESTINAL OBSTRUCTION DIAGNOSES,618,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.48,287.48,
GASTROINTESTINAL AND PERITONEAL INFECTION DIAGNOSES,619,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,216.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,216.53,216.53,
DIGESTIVE MALIGNANCY,620,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,183.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,183.44,183.44,
PEPTIC ULCER AND GASTRITIS,621,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,283.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,283.32,283.32,
ESOPHAGITIS AND OTHER ESOPHAGEAL DIAGNOSES,623,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,161.16,
OTHER GASTROINTESTINAL SYSTEM DIAGNOSES,624,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,184.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,184.17,184.17,
INFLAMMATORY BOWEL DISEASE,626,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.65,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.65,134.65,
"NON-BACTERIAL GASTROENTERITIS, NAUSEA AND VOMITING",627,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,219.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,219.19,219.19,
ABDOMINAL PAIN,628,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.18,255.18,
"MALFUNCTION, REACTION AND COMPLICATION OF GI DEVICE OR PROCEDURE",629,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,302.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,302.52,302.52,
CONSTIPATION,630,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.38,208.38,
HERNIA,631,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,160.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,160.74,160.74,
IRRITABLE BOWEL SYNDROME,632,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,117.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,117.14,117.14,
ALCOHOLIC LIVER DISEASE,633,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.07,185.07,
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,634,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.12,221.12,
PANCREAS DIAGNOSES EXCEPT MALIGNANCY,635,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,211.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,211.1,211.1,
HEPATITIS WITHOUT COMA,636,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,176.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,176.26,176.26,
GALLBLADDER AND BILIARY TRACT DIAGNOSES,637,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,215.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,215.93,215.93,
CHOLECYSTITIS,638,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,309.1,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,309.1,309.1,
OTHER HEPATOBILIARY SYSTEM DIAGNOSES,639,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,180.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,180.3,180.3,
HEPATIC COMA AND MAJOR ACUTE LIVER DIAGNOSES,641,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.13,169.13,
GASTROINTESTINAL VASCULAR INSUFFICIENCY,642,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,226.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,226.44,226.44,
"FRACTURES, DISLOCATIONS, OTHER INJURIES - UPPER EXTREMITY INCLUDING SHOULDER",647,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,285.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,285.13,285.13,
"FRACTURES, DISLOCATIONS AND SPRAINS OF THE SKULL, CRANIUM AND FACE",648,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,326.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,326.55,326.55,
OTHER PATHOLOGICAL FRACTURES W/O MUSCULOSKELETAL MALIGNANCY,649,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.54,273.54,
"FRACTURES, DISLOCATIONS, OTHER INJURIES - LOWER EXTREMITY INCLUDING FEMUR",650,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.38,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.38,281.38,
"FRACTURES, DISLOCATIONS, SPRAINS AND OTHER INJURIES OF THE PELVIS AND HIP",651,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,356.56,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,356.56,356.56,
OTHER INJURIES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE,652,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.33,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.33,147.33,
MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FX DUE TO MALIGNANCY,653,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.2,199.2,
"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",654,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.31,155.31,
CONNECTIVE TISSUE DIAGNOSES,655,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,128.8,
"FRACTURES, DISLOCATIONS, OTHER INJURIES OF THE NECK, UPPER BACK AND CHEST",656,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,312.54,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,312.54,312.54,
"FRACTURES, DISLOCATIONS, SPRAINS AND OTHER INJURIES OF THE LOWER BACK",657,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.78,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.78,173.78,
SCIATICA AND LOW BACK PAIN,658,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.19,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.19,169.19,
"MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE",659,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.46,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.46,195.46,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,660,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.84,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.84,173.84,
OSTEOPOROSIS,662,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.64,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.64,138.64,
PAIN RELATED DIAGNOSES,663,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,144.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,144.8,144.8,
NON-PRESSURE CHRONIC SKIN ULCERS,670,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.79,146.79,
MAJOR SKIN DIAGNOSES,671,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.8,128.8,
MALIGNANT BREAST DIAGNOSES,672,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.16,138.16,
CELLULITIS AND OTHER BACTERIAL SKIN INFECTIONS,673,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,189.66,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,189.66,189.66,
"OPEN WOUNDS, PUNCTURES AND OTHER OPEN TRAUMATIC INJURIES",674,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.36,173.36,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DIAGNOSES",675,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,109.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,109.53,109.53,
PRESSURE ULCERS,676,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,150.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,150.53,150.53,
"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DIAGNOSES",690,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,165.27,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,165.27,165.27,
INBORN ERRORS OF METABOLISM,691,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.32,119.32,
OTHER ENDOCRINE SYSTEM DIAGNOSES,692,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.4,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.4,145.4,
ELECTROLYTE DISORDERS,694,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,245.7,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,245.7,245.7,
OBESITY,695,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,115.88,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,115.88,115.88,
THYROID AND PARATHYROID DIAGNOSES,696,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.75,133.75,
DIABETES WITH OPHTHALMIC MANIFESTATIONS,710,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,188.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,188.82,188.82,
DIABETES WITH OTHER MANIFESTATIONS AND COMPLICATIONS,711,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,163.76,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,163.76,163.76,
DIABETES WITH NEUROLOGIC MANIFESTATIONS,712,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.07,130.07,
DIABETES WITHOUT COMPLICATIONS,713,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,120.95,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,120.95,120.95,
DIABETES WITH RENAL MANIFESTATIONS,714,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,136.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,136.47,136.47,
DIABETES WITH VASCULAR COMPLICATIONS INCLUDING FOOT AND OTHER SKIN ULCERS,715,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,138.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,138.34,138.34,
CHRONIC KIDNEY DISEASE,720,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.93,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.93,149.93,
KIDNEY AND URINARY TRACT MALIGNANCY,721,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.39,140.39,
NEPHRITIS AND NEPHROSIS,722,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.74,169.74,
COMPLEX KIDNEY AND URINARY TRACT INFECTIONS,723,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,255.24,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,255.24,255.24,
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,724,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,172.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,172.21,172.21,
"MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC",725,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,246.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,246.79,246.79,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",726,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.8,167.8,
ACUTE LOWER URINARY TRACT INFECTIONS,727,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.73,237.73,
ACUTE KIDNEY INJURY,729,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,277.22,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,277.22,277.22,
MALE REPRODUCTIVE SYSTEM MALIGNANCY,740,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,143.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,143.77,143.77,
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES,741,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.2,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.2,158.2,
PROSTATITIS,743,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130,130,
MALE REPRODUCTIVE SYSTEM INFECTIONS,744,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,156.39,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,750,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164,164,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,751,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,179.34,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,179.34,179.34,
OTHER FEMALE REPRODUCTIVE SYSTEM AND MENSTRUAL DIAGNOSES,752,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,145.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,145.52,145.52,
LABOR AND DELIVERY RELATED DIAGNOSES,760,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,250.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,250.59,250.59,
POSTPARTUM AND POST ABORTION DIAGNOSES,761,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,217.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,217.14,217.14,
PRETERM LABOR DIAGNOSES,762,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,370.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,370.57,370.57,
ABORTION RELATED DIAGNOSES,763,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,346.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,346.36,346.36,
FALSE LABOR,764,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.89,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.89,218.89,
OTHER ANTEPARTUM COMPLICATION DIAGNOSES,765,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,262.91,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,262.91,262.91,
ROUTINE PRENATAL CARE,766,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,191.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,191.96,191.96,
COMPLICATIONS OF TREATMENT AFFECTING PREGNANCY,767,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,391.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,391.04,391.04,
ANTEPARTUM ENCOUNTERS FOR NON-ROUTINE AND ABNORMAL FINDINGS,768,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,244.49,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,244.49,244.49,
NORMAL NEONATE,770,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.57,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.57,140.57,
NEONATAL DIAGNOSES,771,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,239.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,239.18,239.18,
SUPERFICIAL INJURY TO SKIN AND SUBCUTANEOUS TISSUE,777,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,199.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,199.14,199.14,
OTHER HEMATOLOGICAL DIAGNOSES,780,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,237.85,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,237.85,237.85,
COAGULATION AND PLATELET DISORDERS AND CONGENITAL FACTOR DEFICIENCIES,781,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,147.21,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,147.21,147.21,
SICKLE CELL ANEMIA CRISIS,783,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,287.42,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,287.42,287.42,
"ANEMIA, BLOOD AND BLOOD-FORMING ORGAN DISORDERS",785,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,177.83,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,177.83,177.83,
"AFTERCARE, BURNS, CORROSIONS, OTHER INJURIES RELATED TO THE SKIN AND SUB TIS",787,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,130.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,130.79,130.79,
ACUTE LEUKEMIA,800,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,266.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,266.47,266.47,
"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",801,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,195.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,195.16,195.16,
RADIOTHERAPY,802,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.62,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.62,135.62,
CHEMOTHERAPY,803,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,218.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,218.59,218.59,
LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,804,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.72,173.72,
SEPTICEMIA AND DISSEMINATED INFECTIONS,805,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,592.3,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,592.3,592.3,
"INTRAOPERATIVE, POST-OPERATIVE OR POST-TRAUMATIC INFECTIONS AND COMPLICATIONS",806,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,206.15,
FEVER AND OTHER INFLAMMATORY CONDITIONS,807,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,348.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,348.53,348.53,
VIRAL ILLNESS,808,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,308.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,308.44,308.44,
OTHER INFECTIOUS AND PARASITIC DISEASES,809,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,156.39,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,156.39,156.39,
H. PYLORI INFECTION,810,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,124.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,124.15,124.15,
VIRAL MENINGITIS,812,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,206.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,206.15,206.15,
SCHIZOPHRENIA,820,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,221.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,221.36,221.36,
MAJOR DEPRESSIVE DIAGNOSES AND  OTHER OR UNSPECIFIED PSYCHOSES,821,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,164.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,164.48,164.48,
PERSONALITY AND IMPULSE CONTROL DIAGNOSES,822,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,222.09,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,222.09,222.09,
BIPOLAR DISORDERS,823,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.31,171.31,
DEPRESSION EXCEPT MAJOR DEPRESSIVE DIAGNOSES,824,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.16,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.16,161.16,
ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,825,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.28,161.28,
ACUTE ANXIETY AND DELIRIUM STATES,826,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,213.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,213.15,213.15,
ORGANIC BEHAVIORAL HEALTH DISTURBANCES,827,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,146.97,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,146.97,146.97,
INTELLECTUAL DISABILITY,828,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,149.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,149.45,149.45,
CHILDHOOD BEHAVIORAL DIAGNOSES,829,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,158.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,158.51,158.51,
EATING DISORDERS,830,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,185.5,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,185.5,185.5,
OTHER BEHAVIORAL HEALTH DIAGNOSES,831,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,208.08,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,208.08,208.08,
INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,832,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,454.26,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,454.26,454.26,
OPIOID ABUSE AND DEPENDENCE,840,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,157.72,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,157.72,157.72,
COCAINE ABUSE AND DEPENDENCE,841,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,304.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,304.87,304.87,
ALCOHOL ABUSE AND DEPENDENCE,842,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,286.82,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,286.82,286.82,
OTHER DRUG ABUSE AND DEPENDENCE,843,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,273.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,273.41,273.41,
ALLERGIC REACTIONS,850,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,257.41,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,257.41,257.41,
POISONING OR TOXIC EFFECTS OF MEDICINAL AGENTS,851,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,278.73,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,278.73,278.73,
OTHER COMPLICATIONS OF TREATMENT,852,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,178.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,178.13,178.13,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",853,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173,173,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,854,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,205.12,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,205.12,205.12,
EXTENSIVE 3RD DEGREE OR FULL THICKNESS BURNS,860,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,202.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,202.28,202.28,
PARTIAL THICKNESS BURNS,861,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,173.96,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,173.96,173.96,
ENCOUNTERS FOR CONTACT WITH HEALTH SERVICES,867,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,128.01,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,128.01,128.01,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE INJURIES",869,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.99,133.99,
REHABILITATION,870,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,140.15,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,140.15,140.15,
"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",871,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,174.81,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,174.81,174.81,
OTHER AFTERCARE AND CONVALESCENCE,872,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,167.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,167.32,167.32,
NEONATAL AFTERCARE,873,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,112.67,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,112.67,112.67,
AFTERCARE FOR JOINT REPLACEMENT,874,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,125.36,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,125.36,125.36,
CONTRACEPTIVE MANAGEMENT,875,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,169.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,169.07,169.07,
ADULT PREVENTIVE MEDICINE,876,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,153.13,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,153.13,153.13,
CHILD PREVENTIVE MEDICINE,877,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.02,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.02,133.02,
GYNECOLOGIC PREVENTIVE MEDICINE,878,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,113.52,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,113.52,113.52,
PREVENTIVE OR SCREENING ENCOUNTER,879,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,155.79,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,155.79,155.79,
HIV INFECTION,880,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,241.47,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,241.47,241.47,
AIDS,881,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,247.45,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,247.45,247.45,
GENETIC COUNSELING,882,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,161.04,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,161.04,161.04,
ALTERATION IN CONSCIOUSNESS,883,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,324.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,324.8,324.8,
AUTOPSY AND POST-MORTEM EXAMINATION SERVICES,900,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,119.14,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,119.14,119.14,
USER-DEFINED INPATIENT ONLY PROCEDURES,993,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
USER-DEFINED ALTERNATE PAYMENT METHOD PROCEDURES,994,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
UNASSIGNED,999,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT AND SUPPLIES - LEVEL 1,1001,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT AND SUPPLIES - LEVEL 2,1002,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT AND SUPPLIES - LEVEL 3,1003,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 4,1004,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 5,1005,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 6,1006,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 7,1007,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 8,1008,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 9,1009,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 10,1010,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 11,1011,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 12,1012,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 13,1013,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 14,1014,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 15,1015,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 16,1016,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 17,1017,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 18,1018,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 19,1019,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - LEVEL 20,1020,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DURABLE MEDICAL EQUIPMENT - OXYGEN AND RELATED EQUIPMENT,1021,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
AMBULANCE SERVICES,1030,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
USER DEFINED 340B DRUGS,1090,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DIAGNOSTIC RADIOPHARMACEUTICAL,2000,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
DIAGNOSTIC CONTRAST MEDIA,2001,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL IMAGING SERVICES,2002,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL PHYSICIAN REPORT OR TECHNICAL SERVICES,2003,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL MINOR DIAGNOSTIC TESTS,2004,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL MEDICAL VISIT SERVICES,2005,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL IMPLANTABLE OR OTHER RELATED DEVICES,2006,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL BEHAVIORAL HEALTH SERVICES,2007,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL INTRAOPERATIVE PROCEDURES,2008,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
"INCIDENTAL HOME HEALTH, RESIDENTIAL AND OTHER RELATED SUPPORTIVE SERVICES",2009,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
INCIDENTAL SKIN SUBSTITUTES,2010,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
LEVEL II ALLERGY TESTS,2016,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,47.28,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,47.28,47.28,
NONINVASIVE VENTILATION SUPPORT,2020,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,135.44,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,135.44,135.44,
MINOR MUSCULOSKELETAL PROCEDURES,2030,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,187.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,187.37,187.37,
LEVEL I DRUG SCREENING AND DEFINITIVE TESTS,2040,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,11.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,11.53,11.53,
LEVEL II DRUG SCREENING AND DEFINITIVE TESTS,2041,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,57.61,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,57.61,57.61,
LEVEL III DRUG SCREENING AND DEFINITIVE TESTS,2042,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,134.17,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,134.17,134.17,
LEVEL III BLOOD AND TISSUE TYPING TESTS,2043,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,133.87,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,133.87,133.87,
"LEVEL IV COMPLEX LABORATORY, MOLECULAR PATHOLOGY AND GENETIC TESTS",2044,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,541.58,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,541.58,541.58,
ADVANCED MOLECULAR PATHOLOGY AND GENETIC TESTS,2045,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,1924.23,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,1924.23,1924.23,
HEALTH CARE PROFESSIONAL HOME HEALTH SERVICES,2050,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
OTHER ANCILLARY HOME HEALTH SERVICES,2051,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,APG,,other,Not seperately reimbursable,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,
CLASS I BLOOD PRODUCTS,2061,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,127.59,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,127.59,127.59,
CLASS II BLOOD PRODUCTS,2062,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,281.32,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,281.32,281.32,
MONTHLY CARE AND CASE MANAGEMENT SERVICES,2070,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,50.18,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,50.18,50.18,
MONTHLY BEHAVIORAL HEALTH CARE AND CASE MANAGEMENT SERVICES,2071,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,86.35,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,86.35,86.35,
MONTHLY TREATMENT MANAGEMENT SERVICES,2072,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,42.51,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,42.51,42.51,
BONE CONDUCTION HEARING DEVICE IMPLANTATION,3011,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8522.94,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8522.94,8522.94,
SPINAL IMPLANTATION OF DRUG INFUSION DEVICE,3030,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12155.53,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12155.53,12155.53,
"INGUINAL, FEMORAL AND UMBILICAL HERNIA REPAIR",3033,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,3588.74,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,3588.74,3588.74,
ABDOMINAL HERNIA REPAIR,3035,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4394.07,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4394.07,4394.07,
OTHER TRANSPLANT PROCEDURES,3050,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,4964.75,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,4964.75,4964.75,
HEART AND/OR LUNG TRANSPLANT,3051,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,12821.31,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,12821.31,12821.31,
KIDNEY TRANSPLANT,3052,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,8791.77,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,8791.77,8791.77,
VENTRICULAR ASSIST DEVICE PROCEDURES,3060,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,30049.8,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,30049.8,30049.8,
EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) PROCEDURES,3070,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,7070.37,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,7070.37,7070.37,
EMERGING TECHNOLOGY PROCEDURES,4001,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,697.48,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,697.48,697.48,
LEVEL I OPIOID TREATMENT PROGRAM SERVICES,4010,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,171.55,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,171.55,171.55,
LEVEL II OPIOID TREATMENT PROGRAM SERVICES,4011,EAPG,,,,,outpatient,,,,,,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,379.99,,APG,,other,100% FL Medicaid APG rates for outpatient setting,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,,,,,other,Not reimbursable at APG per contract terms,379.99,379.99,